PRIVATE BUSINESS

London Local Authorities and Transport for London Bill

Considered; to be read the Third time.

CONTINGENCIES FUND 2004–05

Resolved,
	Contingencies Fund 2004–05: Accounts of the Contingencies Fund, 2004–05 showing:—
	(1) a balance sheet,
	(2) a cashflow statement; and
	(3) notes to the account; together with the Report of the Comptroller and Auditor General thereon.—[Tom Watson.]

Oral Answers to Questions

TREASURY

The Chancellor of the Exchequer was asked—

Youth Unemployment

Si�n James: What recent assessment he has made of the economic effects of reducing long-term youth unemployment.

Gordon Brown: It is because of measures we have taken and the new deal that youth unemployment has fallen 90 per cent. since 1997, with large falls in almost every constituency. At a cost of 140 million, we will now pioneer new learning agreements for teenagers, with a grant for training in return for undertaking courses. At the same time, we will offer activity agreements to move teenagers from unemployment back into the world of training and then into work.

Si�n James: I thank my right hon. Friend for his answer. In my constituency we have seen those successes. Some 1,300 young people and 1,080 lone parents have found work as a result of those schemes, benefiting the local economy. Will he ensure that schemes such as the new deal continue to support our local economy and stop young people being put on the unemployment scrapheap?

Gordon Brown: In the mid-1980s, there were nearly 400,000 young people out of work for more than a year. Today, the figure is less than 6,000 throughout the whole country. It is because of the new deal that we have achieved that, and that is why we will not abolish the new deal as the Opposition would do: we will strengthen the new deal with our measures.

David Simpson: What progress is the Chancellor making on funding for the young enterprise programmes across the UK, as the budgets have been cut dramatically?

Gordon Brown: I take a big interest in the enterprise insight programmes. They have been held in England and there are additional programmes in Scotland and Wales, and of course there is a special programme in Northern Ireland, which has been very successful. I am happy to meet the hon. Gentleman to talk about the enterprise programme in Northern Ireland. During enterprise week, only a few weeks ago, hundreds of thousands of young people were involved in the activities and there were 2,000 special events, which ranged from master classes in enterprise to competitions, including one for the young entrepreneur of the year. It is that interest in enterprise and starting businesses among young people that we want to encourage, especially in areas that have seen slow growth in small businesses in previous decades, such as the area that the hon. Gentleman represents. We are determined to do more and I am happy to talk to him about the issue.

Brian H Donohoe: While I praise my right hon. Friend for the massive drop in youth unemployment in my constituency, I am concerned that statistics are not available for the new constituencies north of the border, as he will know. Can he correct that situation so that we can see just how good the figures are for the new constituencies?

Gordon Brown: I am happy to take up that issue with the Scottish Administration, if necessary, so that we can have the full statistics on the decline in youth unemployment, long-term youth unemployment and unemployment generally that has taken place under our Government. I can give him a rough estimate: the decline in youth unemployment in his constituency is of the order of 90 per cent. since 1997.

David Davies: Would the Chancellor agree that the surest way to reduce youth unemployment would be to follow the Irish example and reduce corporation tax, instead of imposing ever more costs, bureaucracy, red tape and taxation on our businesses and stifling their opportunities for growth?

Gordon Brown: I thought that with the new Conservative party we would have heard some concern about the unemployed[Interruption.] We have cut corporation tax by 3p, from 33p to 30p. We have cut small business tax from 23p to 19p. We have cut capital gains tax from 40p to 10p for long-term assets. If the hon. Gentleman is telling me that the solution to long-term youth unemployment is to abolish the new deal, he is living in the world of the 1980s, not 2005.

Martyn Jones: Does my right hon. Friend agree that the proposals that he announced on Monday to make banks give up unclaimed money for the benefit of youth and community programmes will also help long-term youth unemployment?

Gordon Brown: I thought that we might have had a strong welcome for our proposals on the new deal and to put more money into youth and community services through the use of unclaimed assets. The banks and the Government have signed an agreement about what will happen once the figure for unclaimed assets has been agreed. The money will go to financial education, but mainly to youth and community services. That gives us a chance to do something in an area in which we have failed to invest for decadesthe provision of facilities in all our constituencies, be it internet cafes, youth facilities generally or sports facilities. It is important that we do something so that the good, decent majority of young people have facilities to enjoy. I hope that we will receive all-party support for the development of youth facilities through the use of unclaimed assets.

Job Creation

Jim Devine: How many new jobs have been created since 1997; and what assessment he has made of the effect of these new jobs on the economy.

Gordon Brown: As a result of the new deal and other measures, 2.3 million jobs have been created since 1997. British unemployment is half that of Germany and France and below that of America. I can also inform the House that, from April, the new deal will pioneer new compulsory interviews and intensive work preparation courses for those unemployed six months or over so that we can get more people back into work.

Jim Devine: Is my right hon. Friend aware that unemployment in my constituency last week was 2 per cent.? When the Conservative party was in power, it was 26 per cent. We were told that if it was not hurting, it was not working. I worked in primary care psychiatry and watched patients being prescribed anti-depressants and valium. If they could have been prescribed a job, they would not have been near the health centre. Does he agree that there is no such thing as compassionate conservatism?

Gordon Brown: If Conservative Front Benchers had come in on the first question, we might have seen whether their attitude to the new deal had improved since the previous Administration. However, they have appointed a former party leader to run their commission on social action and he is already committed to the abolition of the new deal for young people and the unemployed. My hon. Friend makes a very important point. Conservative Members may have some reason to be grateful to the Government, as unemployment in most of their constituencies has halved as well. We will continue to create more jobs. There are 600,000 vacancies in the economyand this economy has created 300,000 jobs in the past year. We should be congratulated by the Opposition on our policies, not criticised or condemned.

Peter Bottomley: If the Chancellor were to read out the names of the constituencies where unemployment was now higher than it was nine months ago, how many would he name?

Gordon Brown: I do not have a list of 650 constituencies. We have created 330,000 new jobs during the past year. Those, including the Leader of the Opposition, who prophesised that this year we would be unable to create the jobs that we have managed to create will find that we have created 6,000 jobs per week, and that 3,500 new small businesses have been created a week. [Interruption.] I am sorry that Conservative Members cannot congratulate us or feel happy that the economy is creating 330,000 jobs. We are not seeing much evidence of a new Conservative party today.

Andrew Gwynne: As well as the 2.3 million new jobs in the UK, unemployment in my constituency has fallen by 51 per cent. since 1997. Does my right hon. Friend agree that our resources are best used to continue supporting people in finding work, rather than on the waste of the cost of unemployment that we had when 3 million were unemployed under the Tories?

Gordon Brown: People will see that when we mention unemployment and the creation of jobs, Conservative Members in this new anti-Punch and Judy show that they are trying to operate are laughing. The fact is that we have created 2.3 million jobs since we came to power in 1997, and 330,000 jobs have been created in the past year. Some 6,000 jobs have been created on average every week. This has affected almost every constituency in the country. I believe that we are showing that with low inflation, we can create high employment in a modern economy and that we do not have to pursue the polices of the 1980s where, to get inflation down, unemployment was at 3 million. That is the difference between a Labour philosophy and a Conservative philosophy.

Nicholas Winterton: While the Chancellor's figures are encouraging, and I congratulate him, does he accept that the situation facing manufacturing industry is very grim? Many tens of thousands of jobs have been lost in manufacturing, which is the only source of non-inflationary sustainable growth. Is there nothing that he can do to give further encouragement and support by creating the right environment for a growth in manufacturing jobs, which is essential to this country?

Gordon Brown: I am grateful to the hon. Gentleman, who has taken a long-term interest in manufacturing industry. I think that he would agree that the first foundation for industrial strength is low inflation and economic stability. That has been achieved over recent years. What is happening in every advanced industrial country is that the number of manufacturing jobs is declining. America and Japan have each lost 3 million manufacturing jobs. America has lost 1 million manufacturing jobs in the past two years. That trend is happening right across the world[Interruption.] I am sorry; again, the Conservatives must face up to facts. If America and Japan each lose 3 million manufacturing jobs, all advanced industrial economies are affected. What we are trying to doI think that the hon. Gentleman will be interested in thisis to provide greater support for research and development in manufacturing, greater support for the development of new skills, new investment allowances for small businesses and support through the Small Business Service and the regional development agencies. We are trying to help our modern, high skill and high-value-added manufacturing become more competitive across the world. We will continue with that policy, and I am sure that the hon. Gentleman will support it even if those on the Conservative Front Bench do not find it at all interesting.

Madeleine Moon: Will my right hon. Friend confirm that our economic success is a result of his commitment to the TANSTAAFL principlethere ain't no such thing as a free lunchand that economic growth comes from investment in jobs, skills, education and communities, not inflation-busting tax cuts?

Gordon Brown: Our policy is to invest in both jobs and skills in the economy. At some point, the Conservatives must face up to this issue. If we want employment and modern skills, we must invest in the new deal and education. Their policy to cut 12 billion from public expenditure would damage jobs, skills and education.

Michael Fallon: What proportion of the new jobs since 1997 are public service jobs? Why will the Chancellor not give the House the current estimate of the public service pension liability that arises from those new jobs and must then be paid for by the private sector?

Gordon Brown: The hon. Gentleman knows that two thirds of the new jobs are in the private sector and that almost 1 million jobs have been created in small businesses alone. If he wants to cut public sector jobs, perhaps he should look at his election address, in which he said:
	I want more money to go to the front line for more nurses, doctors and clinical staff.
	He than said:
	I want more police.
	That is not someone trying to cut the public sector; it is someone trying to increase it.

Angela Eagle: Does my right hon. Friend recognise how successful the policy of getting down unemployment has been so far, especially in my constituency? Will he give the House some indication of how he intends to take that success further, particularly with skills, so that we can ensure that the jobs that are created in the future for my constituents will be ones that can support families, that are well paid and that are not bumping along the bottom of the labour market?

Gordon Brown: I am grateful to my hon. Friend. Perhaps there could be all-party support for the extension of the national employer training programme, which was announced on Monday, to all areas of the country, where employers will get help so that they can train their workers and get time off, with some support for the wage costs in doing so. That new partnership between the Government, employers and employees involves some public money47 million to help small firms to give time off to their workers. We are prepared to make that public investment. The question is whether the Conservative party is prepared to support the public investment that is necessary for the skills and training that we need in the economy.

Tax Credits

Philip Hollobone: What estimate he has made of the number of people entitled to claim tax credit who do not do so.

Dawn Primarolo: Analysis of the number of those entitled but not claiming tax credits is ongoing and will be completed by the end of 200506. Initial estimates are that 80 per cent. of those entitled to the child tax credit in the first year claimed it. That compares with a take-up of 57 per cent. for family credit and 62 per cent. for working families tax credit.

Philip Hollobone: I thank the Minister for her answer. Although it is encouraging that the percentage take-up is improving, does she share my concern that up to a fifth of potential claimantssome of them the most vulnerable members of our societyare not getting to the tax credits to which they are entitled?

Dawn Primarolo: I assure the hon. Gentleman that take-up of tax credit appears to be across the board, particularly focusing on those in the greatest need; for instance, 1.4 million receive an average entitlement of 5,795 a year. In his constituency, about 8,800 families are benefiting from tax credit. Even with take-up of child tax credit as high as it appears to be, it is important that we focus on ensuring that we continue to advertise it and to encourage people who are entitled to apply for it. I hope that he will campaign for that and support tax credit, to ensure that it is welcomed and supported.

John McFall: My right hon. Friend will be aware that at the Treasury Committee meeting yesterday we asked her officials for a paper on the implications of the latest changes in tax credits. Although the disregard on earnings from 2,500 to 25,000 is a huge step forward, will she inform us whether it will be revenue neutral, and before her next appearance before the Committee will she work with her officials to ensure that innovative ways are found to increase that 80 per cent. take-up?

Dawn Primarolo: My right hon. Friend refers to specific issues and discussions about the package of measures announced on Monday for reform of tax credits, ensuring flexibility but also greater certainty for claimants. He will know that the package as a whole was scored in a particular way in the pre-Budget report statement. I will ensureI think that my officials gave this undertaking to the Treasury Committeethat a detailed answer specifically on costs is not only made available to the Committee but that it is put in the Library so that all Members can see how the entire package fits together in terms of the total costing.

David Laws: When did Ministers first become aware of organised attempts to defraud the tax credit system? How many Department for Work and Pensions staff have been affected by that to date, and can she tell us how much that organised fraud of the tax credit system has cost the taxpayer?

Dawn Primarolo: The hon. Gentleman will be aware, because I have answered him both in parliamentary questions and in letters, that the potential committing of fraud against the tax credit system is taken seriously by officials. He will also be aware that at the end of the first year, 200304, specific figures, which are being prepared, will indicate the success of the policy in deterring fraud. Because of the announcement, he will be aware that there are specific investigations into fraud against the tax credit system involving the DWP. A criminal investigation is going on, so it would not be appropriate for me to comment further, but I assure the hon. Gentleman that I shall keep him and the House fully informed of developments.

Helen Goodman: Will my right hon. Friend tell the House what her estimate is of the number of children who would fall back into poverty if the tax credit system was abolished?

Dawn Primarolo: The combination of measures through the tax credit system has contributed to about 1.4 million children being lifted out of poverty. That is crucial and a central part of the Government's measures to eradicate child poverty, especially the record level created under the previous Conservative Government. Without the presence of tax credits, should the hon. Member for Tatton (Mr. Osborne) feel tempted to abolish them, as the Conservatives say they will do, we would see a massive rise in child poverty.

Philip Hammond: Let me try to help the Paymaster General with the question that the Chairman of the Treasury Select Committee asked. At the same time as the announcement on Monday that the disregard of increased pay would be raised so that people earning more than 90,000 could continue to receive their tax credits in full for up to 12 months, the pre-Budget report showed that the Government intend to spend 200 million less on tax credit in 200708. If people whose income increases will be better off, and the Government plan to spend less on the total package, who will be worse off?

Dawn Primarolo: I will send the hon. Gentleman another copy of the statement that was released as part of the pre-Budget report that was announced by my right hon. Friend the Chancellor on Monday. Let me help him by reminding him that there were a series of reforms that were in favour of claimants because they made the system more flexible. One part of that was the increase to the disregard. There were reforms to speed up the reporting of changes in circumstances to ensure that it would be less likely that overpayment would occur. There was a reform to change the period for verificationthe renewal periodfrom six months to five months. Those are but three of the measures. Taken together, they give claimants greater flexibility while reducing the risk of overpayments. That is how the entire package hangs together and how the costings are developed. If the hon. Gentleman wants to read the statement again so that he understands it, I will be happy to clarify any further confusion that he has.

Inflation

Geoffrey Robinson: If he will make a statement on his policy on inflation.

Gordon Brown: Inflation, which averaged 8 per cent. for the years 1970 to 1997, has been at or around 2 per cent. in recent years. It is forecast to be 2 per cent. this year and next year. It is because of low inflation that interest rates in Britain have averaged 5.5 per cent. since 1997half the level of the previous 18 years.

Geoffrey Robinson: Is my right hon. Friend aware that the Organisation for Economic Co-operation and Development has called the British economy under his stewardship a paragon of stability? Is he further aware that central to that success has been the control of inflation, and that that control of inflation, in turn, has led to the lowest mortgage rate since the late 1950s, which has meant that in my constituencyand, indeed, throughout the countrythe average mortgage holder has saved 4,000? Will he tell the House what the effect would be of returning to the Conservative party's policy of 10 per cent. inflation?

Gordon Brown: I am grateful to my hon. Friend. The number of home owners has increased by 1 million since 1997. That has been possible because interest rates have been half what they were under the previous Government and mortgage rates have also been half what they were in the 18 years of the previous Government[Interruption.] I would have thought that there would have been all-party support for the stability that has been achieved. In fact, the shadow Chancellor has been making speeches in support of our macro-economic policy, but unfortunately he has made them not in the House, but outside the House, where he hopes that his party will not hear what he says.
	The OECD commented on our economy by saying:
	The United Kingdom is a leader in the quality of its monetary and fiscal policy frameworks among OECD countries.
	It also said:
	The stability and resilience of the economy has been impressive and labour and product markets are among the most flexible in the OECD.
	We will continue to maintain stability and increase the flexibility and resilience of the economy. Again, I would have hoped that we would have all-party support for that.

Peter Tapsell: But does the Chancellor have any meaningful inflation policy having handed over control of interest rates to the Bank of England, whose Governor's recent public statements have been markedly more pessimistic that his? Is it not clear that the lack of co-ordination between fiscal and monetary policy severely undermined the authority of the Chancellor's pre-Budget report? Does he recall that a distinguished predecessor of his used to criticise punk monetarism, yet he has now become an exponent of punk Keynesianism, boosting expenditure before the election and restraining it

Mr. Speaker: Order. We are running out of time.

Gordon Brown: There are some members of the Conservative party who remain to be convinced about making the Bank of England independent. I should tell the House that the hon. Gentleman has been consistent in his opposition to Bank of England independence. He said that it would make the efficient macro-economic management of our affairs more difficult and then predicted that it would lead to higher levels of unemployment. Unemployment has gone down by half a million since we came to power and there are 2.3 million more jobs. He should be admitting that he was wrong on the matter and that it was right to make the Bank of England independent.

Patrick McFadden: The Chancellor said that low and stable inflation rates have helped 1 million more people to become home owners since 1997a far cry from memories of 15 per cent. interest rates when the Opposition were in power. However, does he agree that many more people in Britain have the dream and ambition of owning their own home? Will he tell the House how many more people will be helped to do so through the housing measures announced this week in the pre-Budget report?

Gordon Brown: Our aim is that the figure of 1 million extra since 1997 should rise to 2 million by 2010. It is because of the combination of measures that we have introduced to improve the planning system, the use of land, the development of existing land and the improvement of infrastructure, as well as the Government's low interest rate policy that we can aspire to low mortgages and the building of additional houses over the next few years. Opposition Members must face up to the fact that this is a low inflation, low interest rate environment, and that has only happened because there is a Labour Government, not a Conservative Government.

Vincent Cable: In his statement on Monday, the Chancellor argued that because the main cause of recent inflation was high oil prices, petrol duties would be frozen and taxes increased on the North sea. If oil prices fall to the level before the recent shock, is it therefore Government policy that petrol duties will be increased and the increase in taxation on the North sea reversed?

Gordon Brown: The policy on fuel prices is as I have set out previously. As for the North sea, I want to give stability to oil companies during this Parliament.

Michael Gove: By increasing taxes?

Gordon Brown: Opposition Members clearly do not want the revenue of 2 billion a year from the increase in North sea oil taxes, so they had better tell us which services they will cut to make possible the loss of that revenue.

Millennium Development Goals

Barbara Follett: What action his Department is taking towards delivery of the millennium development goals.

Gordon Brown: I can report a major advance that will support progress towards reaching our millennium development goals. Since Britain pioneered the international finance facility for immunisation, I can announce not only the engagement of France, Italy, Spain and Sweden in this project but that Norway has joined the project this week. I believe that other countries are ready to follow and that this initiative alone could save up to 5 million lives between now and 2015. It is one of the most important factors that make possible the achievement of the millennium development goals on infant and maternal mortality.

Barbara Follett: I thank my right hon. Friend for his reply and for everything that he and his Department are doing to try to meet the millennium development goals. However, does he agree that as 140 million children in the developing world, 65 million of them girls, are unable to access education, we have an enormous amount to do if we are to achieve goal 3 and eliminate gender disparity in primary and secondary education by 2015?

Gordon Brown: I am grateful to my hon. Friend, who takes a huge interest in these matters, particularly Africa, where many children are denied the prospect of education. There are 110 million children around the world who will not go to school today. Two thirds of them are girls, who suffer both from discrimination against girls and the lack of resources for education. The world could come together over the next few years with the fast-track action plan for education to speed up the offer of primary places, in particular, to girls as well as boys. The cost of that investment would be about $10 billion a year, which is a small price to pay for probably the most cost-effective investment that the world could ever make. Again, I hope that there will be all-party support for that initiative.

Mark Field: I want to take the opportunity to state that Her Majesty's Opposition support the Chancellor's broad objectives in this sphere. [Interruption.] It could indeed be described as an end to Punch and Judy politics. However, we urge him to provide a full report on further progress on the international finance facility along the lines that he set out, particularly efforts to try to achieve US involvement in this important sphere of work. We recognise that aid alone can never be sufficient. In pursuit of economic development, free trade, especially in agricultural commodities, is of key importance. Will the Chancellor ensure that effective action to reform the EU common agricultural policy, rather than mere words, becomes official Government policy?

Gordon Brown: I am grateful to the hon. Gentleman for his support for our initiative on debt relief and aid and on the international finance facility. We are moving forward with our proposal for the pilot project on immunisation, which will put $4 billion of extra money into vaccinating and immunising children in particular in Africa and Asia. We have won the support of a large number of European countries, and we believe we will have support from Latin America, Africa and Asia over the next few months, so that it will genuinely be a worldwide initiative with dozens of countries supporting the principles underlying the international finance facility. I hope that from the all-party support in the House we can build out to a consensus right round the world.
	On trade, the hon. Gentleman knows I agree with the proposition that there needs to be progress. As he probably saw on Saturday at the G7 Finance Ministers meeting, Brazil made a new offer to open up trade in areas where it has been under criticism, and India indicated that it would make a further offer if there were similar and equivalent offers from Europe and America. It is now up to the trade negotiators to look at those new proposals and see whether we can unblock the trade talks. Of course, at the heart of it, as I said on Saturday, is the vexed issue of agricultural protectionism, where I hope we all agree that both Europe and America must make progress and make new offers.

HIV/AIDS

Julie Morgan: If he will increase the UK's financial contribution to tackling HIV/AIDS overseas.

Gordon Brown: Our aim is that by 2010 every HIV/AIDS sufferer will receive treatment. Advance market commitments for vaccines to prevent diseases that primarily affect poor countries were discussed at the G7 meeting of Finance Ministers at the weekend. We agreed a pilot scheme to be developed, which will support research and development and the delivery of vaccines that in the long term may help us in the search for a preventive vaccine for HIV/AIDS. I hope that there will again be all-party support for those initiatives.

Julie Morgan: I congratulate my right hon. Friend and the Government on all the efforts that they have made in this matter. What can my right hon. Friend do to ensure that the aid that is given for HIV/AIDS is spent as intended? On a recent visit to Kenya, I was told by the Ministry for Health, health professionals and non-governmental organisations that the rules of the International Monetary Fund made it extremely difficult for them to increase their public spending on nurses, doctors and other health officials. What can my right hon. Friend do to influence the situation and create the right balance between economic stability and public spending on health in countries such as Kenya?

Gordon Brown: As my hon. Friend may know, the British Government and other European countries in particular are signing agreements with a number of countries to give long-term support to those Governments so that they can make allocations to health and education, not just on an annual basis, but on a sustainable basis. We believe that that is the best way of ensuring that money goes to health and education, rather than going to corrupt projects or being wasted. As regards the short term, I will take up my hon. Friend's question about Kenya with my hon. Friend the Minister with responsibility for overseas development and write to her on the matter.

Jeremy Hunt: Does the Chancellor agree that the 2010 access to AIDS treatment target will not have any credibility unless intermediate targets and milestones are set by which we can measure whether progress is being made towards the achievement of such an important target?

Gordon Brown: I accept that when a long-term target is set, the real questions are whether there will be the money to deliver that target, and whether there will be proper development of policy to achieve it, so I agree with the hon. Gentleman that we must put in place both the necessary resources and the policy measures to achieve the target. There have been great advances in antiretroviral drugs and treatments, and great advances also in charitable and other medical projects that are helping AIDS sufferers in various parts of AfricaI visited some of those projects in the course of a visit to Africabut in the end it will require an agreement about the funding that we can provide, as well as the policy measures to implement it. I am glad that there is all-party agreement on that.

Economic Regeneration Funding

Matthew Taylor: What progress has been made on Government proposals to repatriate economic regeneration funding from the EU.

Ivan Lewis: The Government's approach to the reform of structural and cohesion funds for the period 200713 has called for greater focus on new member states, more freedom and flexibility for structural fund spending within member states, and a greater focus on the Lisbon agenda for productivity and growth. That approach is set out in the negotiating box tabled by the Foreign Secretary on Monday 5 December, which reflected the views of all member states.

Matthew Taylor: Before the general election, the Chancellor pursued a policy of getting billions back from the European Union to the UK by repatriating regeneration funds. Since the general election, it seems that the Prime Minister has been pursuing a policy of giving away billions of pounds to the EU by giving up part of our rebate. What is the Treasury view on this apparent U-turn in policy?

Ivan Lewis: We do not accept that that analysis is accurate. The negotiations are ongoing, and we cannot make commitments on specific regions. Under the UK proposals, which were tabled this week, receipts would be the same as those under the previous proposals from Luxembourg. It is important to recognise that three quarters of regional funding is already provided domestically. This year, the South West of England Regional Development Agency has a budget of 153 million to invest in the economic development and regeneration of Cornwall and the wider south-west region.

Andrew Love: When my hon. Friend considers the future of structural funding, will he take into account the decision by my Conservative-controlled local authority to turn down 1 million of economic development funding because it does not want to match fund, which will affect the most vulnerable and deprived in my community? Is that not an early example of the hypocrisy and double standards of the Conservative party?

Ivan Lewis: Of course, I agree with my hon. Friend. However the Conservative party tries to rebrand itself, it will always stand for the same ideology and philosophy, which does not involve using resources to help some of our more disadvantaged communities. Any decisions that we make in the future will take account of that local authority's failure to provide the right local leadership.

Adam Price: In the proposals set out on Monday, the Government are offering more flexibility on the timing of expenditure and the required level of match funding in return for a 10 per cent. cut in the structural funds compared with the Luxembourg proposals Will the Minister confirm that that new flexibility will be available to convergence fund regions in the UK such as west Wales and the valleys as well as to the EU 10?

Ivan Lewis: As I have said, the most important difference that we make involves the money that we spend in the United Kingdom on regional policy. We will take account of the concern expressed by the hon. Gentleman.

Chris Bryant: The Minister knows that because of the extraordinary success of this Government's economic policy, Wales in particular has strode ahead economically, so much so that we may no longer qualify for funds that are available to regions because of poverty. Will he guarantee that whatever happens in the EU negotiations over the next two weeks, he will continue to work with colleagues in the Welsh Assembly to make sure that the economy in the south Wales valleys continues to be regenerated?

Ivan Lewis: I agree with my hon. Friend. A combination of macro-economic stability and labour market intervention through the new deal to create new jobs has been at the centre of the Government's policies on social justice and economic growth. Those policies will continue, and we will continue to work with elected representatives in Wales to ensure that the prosperity that is developing continues to grow into the future.

Richard Spring: In his Mansion house speech, the Chancellor talked about the necessity of EU economic reform, and the Prime Minister has subsequently discussed budgetary reform. Could the Government ever have imagined that issues such as economic regeneration funding would inflame the new member countries and have the French running rings around us over the common agricultural policy? Given that our EU presidency has been marked by isolation, incompetence and lack of preparation, will the Minister take this opportunity to apologise for both the lack of reform and our national humiliation?

Ivan Lewis: That contribution demonstrates why the Conservative party will never be fit to be in government. We are in the middle of the most sensitive negotiations and hold the EU presidency, and Her Majesty's Opposition are seeking to undermine the Government in those negotiations. The only change on abatement occurred because we believe that we should pay our fair share of the costs of enlargement. Does the Conservative party believe that we should pay our fair share of the costs of enlargement?

Keith Vaz: Of course the Minister is right that the first duty of any Government in negotiations is to protect Britain's position but, as he also said, there is a cost to enlargement. The Conservatives supported enlargement, as did the whole European Union. It would be completely unfair to hamper the new member states because they do not have the funds fully to integrate into the European Union. I wish my hon. Friend well in the negotiations and ask him to remember that the future of Europe depends on our ability to treat all nations equally, which means giving the necessary funds to new member states.

Ivan Lewis: I entirely agree with my hon. Friend, who has a lot of expertise in this area. The changes that we have made to the negotiating position so far are about ensuring that this country pays its fair share of the costs of enlargement. I assume that the Conservatives would believe that to be the correct policy. We will be willing to make other significant changes in terms of the rebate only if the French radically change their position on the common agricultural policy. That has remained this country's position throughout the negotiations.

UK Economy

Tim Boswell: What assessment he has made of the principal factors affecting the estimated level of growth in the UK economy.

Des Browne: The pre-Budget report 2005 set out a comprehensive account of recent economic developments and the Government's assessment of growth prospects for the UK economy. Over the past year, the effects of global and domestic inflationary pressures have tested the UK economy. However, sound macro-economic fundamentals continue to support growth and stability, helping our economy to remain far more resilient to challenges and shocks than it has in the past.

Tim Boswell: In the new spirit of consensus, and because I suspect that the Chief Secretary would agree that economic growth is the bedrock not only of individual prosperity but of any social advance, does he share my concern about the very sharp decline in the rate of economic growth in recent months?

Des Browne: I do agree. However, the bedrock of economic growth is stability. Through the macro-economic framework, we have provided the stability to engender the growth that is necessary to create the wealth of which the hon. Gentleman speaks. We have a record of economic growth that would have been the envy of any previous Government. We have grown consistently.

Jim Cunningham: May I suggest to my right hon. Friend that one way to develop growth is by improving skills and research and development? What is he doing about that, particularly in relation to the west midlands, which traditionally has had a manufacturing base?

Des Browne: I thank my hon. Friend, who has been a consistent champion of those issues on behalf of his constituents and the west midlands. As my right hon. Friend the Chancellor said earlier, the whole developed world faces the challenge of retaining manufacturing jobs. We need to decide what is the Government's role and what their response should be to those who are challenged in such circumstances. We have set out to respond in a way that allows people to develop the skills that are necessary to face the challenges of the 21st century. Earlier this week, in his pre-Budget report, my right hon. Friend explained how we will further invest in innovation, research and development and the creative industries to develop those opportunities and skills.

Brooks Newmark: In last year's autumn statement, the Chancellor said that in the previous Budget
	I forecast growth . . . of between 3 and 3 per cent . . . Even after the doubling of oil prices.[Official Report, 2 December 2004; Vol. 428, c. 784.]
	We all know that oil prices have doubled and his forecast is halved. Does the Minister agree that the Chancellor's judgment in this matter is flawed, as it is in other matters?

Des Browne: The hon. Gentleman's basic facts are wrong. Oil prices were $40 at the beginning of the year and rose to $70. A combination of factors have generated a set of circumstances that have challenged this country's growth, but the resilience of our stable economy has allowed us to continue to grow. Because of that, and because of the stability that is in the economy, we can look forward to increasing growth as forecast in the pre-Budget report.

Sally Keeble: Does my right hon. Friend agree that skills are especially important in areas such as Northamptonshire where growth has been high and the labour market is tight? What is he doing to encourage staying-on rates at school to provide support for families so that people do not leave school without skills and we can thus improve the skills base of our work force?

Des Browne: My hon. Friend makes an important point. We introduced the education maintenance allowance to develop the skills that tight labour markets such as that in her constituency need. I do not have the exact figures for education maintenance allowance in her constituency, but I am sure that, as an assiduous Member of Parliament, she knows them already.

George Osborne: When was the Chief Secretary first told that the Chancellor's hopelessly optimistic pre-election growth forecast was likely to be wrong?

Des Browne: The hon. Gentleman knows that those matters change over the course of the year. I cannot specifically remember when I was told and I am sure that that is not the point of his question. However, he knows that the Office for National Statistics, which tries to calculate growth and other matters that affect the economy, often has to revise its figures retrospectively. I am confident that, even for this year, it will have to revise its figures.

George Osborne: The Government fought an election promising a strong economy this year. We simply want to know when the Chancellor and the Chief Secretary knew that they could not keep that promise.
	Let us consider another promise that the Chancellor made. He is keen to point out how young he is feeling these days, but when he was young and doing my job, he said:
	Raising the trend growth rate of the economy will be an objective of the next Labour Government.
	Will the Chief Secretary confirm that page 186 of the pre-Budget report contains an admission that the trend growth ratethe long-term growth rateof the economy will be lower than it was in 1997?

Des Browne: The average growth rate[Interruption.] The average trend growth rate for the economy is 2.7 per cent. and has risen from an average 2.2 per cent. when we came to power. We have achieved that. The hon. Gentleman had five opportunities in the first six questions to ask the Chancellor his questions. Why does he have to ask them through me? [Interruption.]

Dennis Skinner: Is my right hon. Friend aware that in the 1970s and a lot of the 1980s, we would have thanked our lucky stars in the coalfield areas for growth of 1.75 per cent.? The only thing growing then were the lines of coke in front of boy George and the rest of them.

Mr. Speaker: Order. This seems to be a trend with the hon. Gentleman. He must withdraw that remark.

Dennis Skinner: It was in the News of the World.

Mr. Speaker: Order. The hon. Gentleman must withdraw the remark.

Dennis Skinner: No, I will not withdraw it. It is true.

Mr. Speaker: Order. If the hon. Gentleman does not withdraw the remark, he must leave the ChamberI order the hon. Gentleman to leave the Chamber. I am forced now to name the hon. Gentleman. I name Dennis Skinner. He is withdrawinghe has taken my advice.

Michael Penning: You named him.

Mr. Speaker: I know what I have done. The hon. Gentleman has moved and that is the main thing.

British Film Industry

John Whittingdale: What representations he has received in response to his proposals for tax incentives to support the British film industry.

Dawn Primarolo: The Treasury consulted extensively with the industry on the proposed new film tax between July and October this year. The consultation informed the announcements on film tax in the pre-Budget report. They included allowing films costing up to 20 million a guaranteed minimum benefit worth 20 per cent. of qualifying production costs and a benefit worth 16 per cent. for films costing more than 20 million. The incentives will be even more valuable for profitable films. That can help achieve our goals for greater sustainability for the British film industry. The industry has warmly welcomed the announcements.

John Whittingdale: When I tabled this question, I intended to be critical of the Chancellor, but, in keeping with our new spirit, I warmly welcome the measures that were announced in the pre-Budget report. However, the Minister will be aware that the uncertainty that has surrounded the fiscal arrangements for the industry has already led to some major film productions being made abroad. Will she confirm that the new measures will not be subject to change, so that the industry can now plan ahead with total certainty?

Dawn Primarolo: I welcome the hon. Gentleman's conversion to supporting the Government. In fairness to him, he has taken an interest in assisting the development of the British film industry for a considerable time. I can confirm that the measures will produce a stable regime for the industry, and that they will be effectively targeted to ensure that we support the producers. If the hon. Gentleman has time to look again at the pre-Budget report, he will also see the announcements regarding the transition from the present regime to the new one. Consultations with the industry are still going on, which is important, but there is general agreement that the measures will offer a stable regime to help the development of the industry.

Paul Farrelly: My right hon. Friend will be aware that a good reason to change the tax regime for the film industry was to clamp down on tax avoidance. Following the pre-Budget report, she will know how much we all enjoy blocking gaping tax loopholes, whether they relate to film, fine wines or property speculation. How confident is she that the new film industry regime will be generous enough to help UK film producers while being robust enough to prevent yet another spawning of the so-called tax avoidance industry?

Dawn Primarolo: I can inform my hon. Friend, who also follows these matters with interest, that the incentives will now be more effectively targeted, and therefore less vulnerable to manipulation and avoidance than the current reliefs. It is, however, almost impossible to anticipate the creativity of the avoidance industry. The film industry has welcomed the proposals, saying that they are the best news in five years. They will ensure the security of the regime. I would say to my hon. Friend, however, as I have said to the industry, that if there are any signs of avoidance, we will clamp down on them immediately.

Work Force Skills

Sarah McCarthy-Fry: What assessment he has made of the impact of the level of skills in the work force on the level of employment.

John Healey: A highly skilled work force is one of the important drivers of economic growth, and people without skills are much less likely to be in employment. The Leitch review of skills, which was published in the interim report on Monday, set out the evidence on the links between work force skills and employment.

Sarah McCarthy-Fry: Does my hon. Friend agree that it is never to late to learn new skills, and that, as well as training our young people, we should also provide retraining opportunities for older people, so that they, too, can take advantage of the employment opportunities in the high-skills sectors?

John Healey: I do indeed. When one in six adults do not have the literacy levels of our 11-year-olds, when 5 million people in the work force today have no qualifications, and when 70 per cent. of our work force of 2020 have already left school, the imperative for greater investment in training, particularly for adults, becomes very clear. We must better direct that training to produce the skills that people need and that employers need, and to help people to become more productive at work.

Adam Afriyie: Does the Minister believe that it is the level of skills in the British economy that has caused the continuous rise in unemployment over the past eight or nine months?

John Healey: No. All the evidence suggests that an increase in the level of skills increases people's employment opportunities. Any Government who were not prepared to invest in the skills of the work force would simply be failing in their duty to equip our companies and our people for the future. Any Government who were prepared to allow spending to grow at a slower rate than the growth in the economy would have to make huge cuts in public spending, and would not be able to support the skills that our economy needed.

Si�n Simon: The Leitch review showed that the total proportion of the work force with skills had risen to 86 per cent. Presumably that has something to do with the fact that the number of jobs in the economy has risen by 330,000 to a record leveland that, presumably, has something to do with the fact that the level of growth remains positive, as it did not under the Tories. As the hon. Member for Tatton (Mr. Osborne) has made it clear that he does not understand what is going on, can we ensure that I do? Is it possible for the Government to build on all those developments by scrapping the new deal?

John Healey: The new deal has helped more than 1 million people into work, but we must make it a new deal for jobs and skills. The employment prospects of people who can now expect to change jobs seven times during their working lives mean that they will have to train and retrain. Unless we have a skills programme to help our people through the changes that our economy faces increasingly in a global context, we shall fail the future of the country and, more important, the people of the country.

Musicians (National Insurance)

Sammy Wilson: If he will make a statement on the recent change in the application of the rules on national insurance contributions to freelance musicians and singers.

Dawn Primarolo: There have been no recent changes in the application of the rules on national insurance contributions to freelance musicians and singers.

Sammy Wilson: Is the Minister aware that as a result of the change in the rules on class 1 national insurance contributions from freelance musicians, orchestras throughout the United Kingdom will face a bill of 33 million, because the change is backdated to 2001? That will bankrupt many regional orchestras, such as the Ulster orchestra. Given that the development was completely unexpected and orchestras could not budget for it, will the Paymaster General consider either a total or a partial exemption from the backdated liability?

Dawn Primarolo: I repeat that there have been no recent changes in the application of the rules on national insurance contributions to freelance musicians and singers. The last set of changes occurred in 1998. I do know that, as a result of a compliance check, it has been revealed that some employers have not been paying their class 1 national insurance contributions in respect of some musicians and singers. Her Majesty's Revenue and Customs is holding discussions with the Association of British Orchestras, the Musicians Union, the Arts Council and the Department for Culture, Media and Sport to find out exactly how much may be in question, and how to resolve the issue so that our orchestras can continue to provide a fine service for our community.

Business of the House

Chris Grayling: May I ask the Leader of the House to give us the business for next week?

Geoff Hoon: The business for next week will be as follows:
	Monday 12 DecemberSecond Reading of the Armed Forces Bill.
	Tuesday 13 DecemberThere has been a change from what was originally announced. Second Reading of the Criminal Defence Service Bill [Lords], followed by proceedings on the Consolidated Fund Bill, followed by a motion to approve a money resolution on the Climate Change and Sustainable Energy Bill.
	Wednesday 14 DecemberA debate on European Affairs on a motion for the Adjournment of the House.
	Thursday 15 DecemberRemaining stages of the National Insurance Contributions Bill.
	Friday 16 DecemberThe House will not be sitting.
	The provisional business for the following week is as follows:
	Monday 19 DecemberA debate on police restructuring on a motion for the Adjournment of the House.
	Tuesday 20 DecemberMotion on the Christmas recess Adjournment.

Chris Grayling: I welcome the Leader of the House back to his place. What with all the reshuffle speculation on both sides of the House this week, I wondered whether he would be here after weekend reports suggesting that he might move to the twilight zone of the Government Chief Whip's Office. Does he agree that, as there is clearly not to be a Government reshuffle this week, it is time to change the session of questions to the Chancellor of the Duchy of Lancaster? It is now five weeks since the resignation of the Secretary of State for Work and Pensions and the reshuffle of the former Chancellor of the Duchy of Lancaster, but there has still been no appointment. Many people will see that as a major downgrading of the importance of the Cabinet Office, but if it is what the Prime Minister does intend, let it at least be reflected in the business of the House.
	I am glad that there is to be a debate on the police. The more mischievous of those who were here for last week's business questions unfairly suggested that the purpose of the Leader of the House's important ministerial visit overseas was to avoid the flak that his hapless deputy took over the question of a police debate. Members on both sides of the House will be grateful that the right hon. Gentleman has changed his mind and put the police debate into the business statement, but will he also agree to hold the debate on a substantive motion? He spoke about an Adjournment motion, but the House should have the opportunity formally to express a view about this important issue.
	Now that the Leader of the House has accepted the mood of the House over policing, will he do the same with respect to another extremely important issueenergy supplyand fulfil the Government's promise to hold a debate on that important issue in their own time? The right hon. Gentleman and I have already exchanged views on energy issues this winter, but the last few weeks have seen the resurgence of debate over the future of nuclear power. Is it not high time that the House had the chance to debate that extremely important policy area?
	Is it not also high time that the Government provided the House with fresh information about the Hong Kong trade talks? Time and again this autumn, I have reminded the right hon. Gentleman about the strong views held on both sides of the House on trade justice issues. Why have we not had a statement ahead of those talks? Why are we not being told by the Ministers who will represent us in those talks what their plans are, what is happening and whether there is any hope for a promising outcome?
	Finally, I congratulate the Leader of the House on the interview that he gave to epolitix.com back in September. When asked about his political ambitions, he said:
	The Conservatives need to be revived . . . it is good for our democracy that we have a strong opposition.
	I hope that he shares my pleasure that his political ambitions are now being fulfilled.

Geoff Hoon: Of course, I am delighted that the hon. Gentleman is still in his place and still continuing his shadow role. I just hope that he has not been spending too many of the last 24 hours with his telephone.
	On the Chancellor of the Duchy of Lancaster, that is a matter for the Prime Minister, who will resolve it in good time. I am sorry that the hon. Gentleman, having whinged about not having a debate on police restructuring, is whingeing again now that we are having one. Clearly, whingeing is the current stance on the Conservative Front Bench, but I suppose that I should not be particularly surprised about that. I am sure that, in due course, we will have time to debate energy supplies and, indeed, trade justice issues. As the hon. Gentleman rightly says, important negotiations on trade justice issues are about to commence.
	I stand entirely by what I said in the interview to which the hon. Gentleman referred: I want to see the Conservative party continue as a strong Opposition for a very long time.

Frank Field: Earlier this week, the Government announced that they were consulting widely outside the House on the Pensions Commission report. On our return after the Christmas recess, may we have an Adjournment debate on the subject so that Members can also offer their views to the Government?

Geoff Hoon: I am grateful to my right hon. Friend for raising an issue that is regarded as important throughout the House and, indeed, throughout the country. I certainly anticipate that we will have opportunities to debate that important issue and I shall certainly try to find time to debate it as soon as possible.

David Heath: I welcome the debate on police restructuring, but can we have an urgent debate on the Metropolitan police's use of section 132 of the Serious Organised Crime and Police Act 2005? It was sold to us on the basis that it was intended to prevent terrorist acts against the House, but it has now been used to convict a young lady, Maya Evans, for reading out by the cenotaph a list of British soldiers killed in action in Iraq.
	May we have an urgent debate on the landmark judgment by the House of Lords today that evidence obtained from torture anywhere in the world is not admissible in legal proceedings of any sort in this country? I note that the noble Lord Brown of Eaton-Under-Heywood said:
	Torture is an unqualified evil. It can never be justified. Rather it must always be punished. So much is not in doubt.
	I hope that the House agrees with those sentiments.
	That leads me to ask for an urgent debate on what is euphemistically called extraordinary rendition. The Prime Minister, in an extraordinary response to my right hon. Friend the Member for Ross, Skye and Lochaber (Mr. Kennedy), said:
	In respect of airports, I do not know what the right hon. Gentleman is referring to.[Official Report, 7 December 2005; Vol. 440, c. 863.]
	I do not know whether he was surprised or being disingenuous, but the facts have been widely published and come from authoritative sources. May we have a debate in which we can ask how long we have acquiesced in the United States' policy, for what reason there have been so many of these flights and why the Foreign Secretary has been busy writing to the US Administration asking what all this is about, given that it is clear that the Prime Minister has known all along?

Geoff Hoon: First, all hon. Members would expect to see the law of the land upheld. I am sure that that is true of the Liberal Democrats, although sometimesif I may speak frankly to the Housethe hon. Gentleman chooses which laws he believes should be upheld. In this case, legislation that is widely supported in this House requires that an application be made before a demonstration can be organised. That legislation has worked remarkably well. Since it came into force on 1 August, there have been some 63 applications for demonstrations; those have been granted and demonstrations have taken place perfectly properly. In the particular case to which the hon. Gentleman refersin rather hysterical terms, as eversuch an application was not made. There was no good reason for not making an application, other than simply to challenge the law. There is a strong tradition in western democracy of people seeking to challenge laws with which they disagree, but of course, those people recognise that the consequence of doing so is that they then face criminal penalties. That is precisely what happened in this case.
	The Government will have to study this morning's decision by the Law Lords extremely carefully. We do not in any way condone the use of torture, and a complex decision of this kind obviously needs careful analysis. But again, I hope that all hon. Members will support the Government and me in saying that we as a country must use effective measures to deal with the threat of international terrorism. I hope that that applies even to the Liberal Democrats.
	The hon. Gentleman will know full well that there is no exact definition of rendition. My right hon. Friend the Foreign Secretary has written to the US Secretary of State on the question and has received a full and detailed response. I hope that both my right hon. Friend's statementand, indeed, that of the US Secretary of Stateis a very full explanation of the position.

Barbara Keeley: There is great concern about attacks on firefighters; indeed, there have been 185 incidents against fire crews in Greater Manchester so far this year, and it is unfortunate that a high proportion of those have been in Salford. Following this, the Greater Manchester fire and rescue service, the Chief Fire Officers Association and the Manchester Evening News have got together and are campaigning with Greater Manchester MPs to bring our legislation into line with that in Scotland. In the light of that, does my right hon. Friend agree that we should have a debate on the safety of fire crews, and will the Government consider supporting the private Member's Bill introduced by my right hon. Friend the Member for Swansea, West (Mr. Williams)?

Geoff Hoon: I am very grateful to my hon. Friend for raising this important subject, which has been raised, for example, by the Trades Union Congress on behalf of a wide range of public servants. The shocking fact has been highlighted that public servants doing their very best to help protect members of the public are being subject to attack in the course of carrying out their duties. This problem is not isolated to firefightersit is faced by a number of other dedicated and distinguished public servants. I find that deeply shocking and my hon. Friend is right to raise this issue. The Government obviously must have careful regard to it and take action, if we can, to demonstrate ways in which to prevent these appalling acts of violence against dedicated public servants. My hon. Friend, other Members and I will want to pay tribute to the work that firefighters in particular do on behalf of all our communities.

Mark Harper: I should like to support the earlier comments of my hon. Friend the Member for Epsom and Ewell (Chris Grayling). The Leader of the House and I have been present for business questions in recent times, so he and I both know that the mood of the House was very much for a debate on police restructuring on a substantive motion, thereby allowing the House to express an opinion. Given that he has returned from his overseas visit in a more refreshed mode and has granted that debate, perhaps he might find time to go on another trip, so that he can return next week and tell us that we can have a debate on a substantive motion, allowing the House to express an opinion on a matter that the Home Secretary has said is more important than any other on his current agenda.

Geoff Hoon: I am always extremely grateful for protestations of concern about my health and welfare, especially from Opposition Members. I shall be representing the UK next week at the European Parliament in Strasbourg, and I hope that that will have a suitably refreshing effect. It is sad that, for five years, it did not have that effect on the right hon. Member for Bromley and Chislehurst (Mr. Forth), but as we approach the Christmas season I hope that all hon. Members will be refreshed at the prospect of a break.

Ian Austin: May I ask whether it might be possible to have a debate about the way that local authorities close primary schools? In my constituency, Dudley's Conservative-controlled council plans to close two very good schools, Highfields primary and Sycamore Green. The consultation process has been very unsatisfactory, to say the least. The council has failed to consider any alternatives, such as Sure Start schemes, children's centres or other community facilities, and it has not even replied to letters and petitions submitted by parents and governors who, together with councillors Ridney, Finch, Davies, Aston, Mottram and Johnson, have fought such a great campaign.

Geoff Hoon: My hon. Friend raises an important issue. Clearly, it is extremely worrying for parents of children at primary schools if they do not have the opportunity to participate in proper consultation about closure proposals. I am grateful to my hon. Friend for raising the matter in the way that he has.

Grant Shapps: Earlier this year, the Prime Minister told Parliament that special advisers should be made to attend Select Committees on exactly the same basis as civil servants, yet last month he blocked his own special adviser, Lord Birt, from attending the Select Committee on Public Administration. May we have an urgent debate on the matter? To many of us, that seems like a case of the Prime Minister saying one thing in public and doing something completely different in private, when it comes to his own business.

Geoff Hoon: I am sorry that the hon. Gentleman was not present two weeks ago when this matter was raised, as he would have heard my comprehensive answer. Perhaps he could spend his time over the Christmas recess profitably by studying the Osmotherly rules, which set out very precisely the circumstances in which Ministers may give permission for civil servants, special advisers and others to represent them before Select Committees. Those rules have been in place for a long time, and the point is that they have not changed.

David Taylor: There is often a degree of scepticism about the value of business questions and early-day motions. My early-day motion 1123 states:
	[That this House believes that the proposal to offer tax relief on the purchase of homes under the Self-Invested Personal Pension Scheme rules commencing in April 2006 provides insufficient public benefit, will encourage the purchase of second homes, and will put Her Majesty's Revenue and Customs in a difficult policing position in regard to the pensionholder's use of a property; notes that the investment industry's estimates of the volume of this business far exceeds the Government's and that there may be a higher loss of taxation than expected; and calls upon the Government to apply the tax relief solely to homes made available for social housing, and to ensure that such homes are offered free of rent to the social housing provider managing the property.]
	The motion deals with self-invested personal pensions, an issue that I have raised several times. I am pleased that my right hon. Friend the Chancellor of the Exchequer has seen fit to withdraw the second home option from that particular tax incentive.
	Will my right hon. Friend the Leader of the House say whether there has been any indication from the Treasury team that the second recommendation in that motion will be taken up? It proposes that such incentives might be allowable if the home concerned were made available for social letting at an affordable rent. Such housing is in very short supply in parts of my constituency.

Geoff Hoon: My hon. Friend is a near neighbour of mine in the east midlands, and I have never doubted his influence, or his ability to change Government policy. My right hon. Friend the Chancellor takes very seriously the expressions of opinion in early-day motions. Clearly, he has responded with alacrity to my hon. Friend's proposal, but whether he will do so in relation to the second limb of the motion remains to be seen.

Peter Robinson: It is several weeks since the Secretary of State for Northern Ireland was able to sneak into a Belfast hotel and announce to journalists plans for the review of public administration in Northern Ireland. Those plans affect education, health and planning, and completely turn local government on its head. The right hon. Gentleman has yet to come to this House to be answerable to hon. Members for his actions. Will the Leader of the House arrange for Government time to be made available for the Secretary of State to do just that?

Geoff Hoon: The hon. Gentleman and I disagree on only one aspect of this matter. My right hon. Friend the Secretary of State for Northern Ireland spends every day looking for ways to improve public administration and the standard of life for people in what is an important part of the UK, and continues to do so. Obviously, it is important that he discusses and debates those matters with those hon. Members who represent Northern Ireland, and I am sure that he will give the hon. Gentleman every opportunity to raise these matters with him.

Lindsay Hoyle: Now that regional government is dead and buried, can my hon. Friend arrange for a Grand Committee to be set up to represent the regions? It is embarrassing that we should have bureaucrats and quangos who are accountable to nobody. Why not make them accountable to a Grand Committee representing regions such as the north-west, which is bigger than Scotland and has more representation in Parliament? We should have a say on how the money is spent or wasted.

Geoff Hoon: My hon. Friend makes an interesting suggestion and I assure him that the Government will consider it carefully. However, he makes an unfortunate observation about the role of civil servants in the regions. They are of course accountable to this Parliament through the Minister who is responsible for their activities, and that has not changed. One of the benefits of having civil servants operating in the regional centres is that they are closer to the people whom they affect by their decisions. That is something that I would have thought that my hon. Friend would welcome.

Stephen Hammond: Earlier this year the South-West London health authority concluded its consultation, Better Healthcare Closer to Home. It concluded that Merton and Sutton needed six local care centres and one acute hospital. However, there was some disagreement about that and the hon. Member for Mitcham and Morden (Siobhain McDonagh) objected and referred the consultation to the Secretary of State for Health. She did so in late June. The subsequent delay is harming my constituents' prospects of getting better health care at the Nelson hospital. Will the Leader of the House ask the Secretary of State to make a statement on the delay, give reasons for it and give a date when we might receive the result of her deliberations and the rationale behind them?

Geoff Hoon: I am obviously not familiar with the particular circumstances that the hon. Gentleman sets out, but I assure him that I will bring the matter to the attention of my right hon. Friend the Secretary of State for Health and invite her to write to him directly.

Geraldine Smith: My right hon. Friend and other hon. Members may not be aware of recent changes to the accommodation provided for the Members' post office. The sorting room, rest area, stationery lockers and storage facilities have all been removed and the sorting of Members' mail has to be carried out in a tiny room. Could my right hon. Friend investigate that matter for me and report back to the House? It is not clear who made the decision to change the accommodation facilities.

Geoff Hoon: Again, that is a matter of which I was not aware before today's proceedings, but I will certainly look into it and get back to my hon. Friend in due course.

Paul Rowen: The Leader of the House may be aware of the inquest into the deaths of 91 victims of the Asian tsunami. However, the inquest is not considering the support given by the Foreign and Commonwealth Office to the UK victims. One statement by the Permanent Secretary has caused great offence and upset. He claimed that the support given exceeded our expectations. As one who was caught up in the tsunami, I can say that what support was given was at best ineffectual and at worst inept. May we have a debate on that topic?

Geoff Hoon: I am sure that the hon. Gentleman will understand why I do not comment on current proceedings before an inquest. However, there has been a thorough and detailed report on the way in which the FCO dealt with the immediate aftermath of the tsunami. It contains some criticisms, which have been acknowledged by my right hon. Friend the Foreign Secretary, and it is an indication that we must learn lessons and be in a position to anticipate such terrible tragedies in the future. That acknowledgement by my right hon. Friend indicates that we take seriously our responsibilities and that we will learn lessons from that terrible tragedy.

Jim Cunningham: May we have a statement or a debate on the establishment of a new railway station outside the Ricoh arena in Coventry? This matter has dragged on for far too long and it needs to be pushed. I am sure that I speak for my two Coventry colleagues.

Geoff Hoon: I have driven by that magnificent new stadium and seen the facilities now available for the people of Coventry, so I recognise why my hon. Friend makes his suggestion. I will draw it to the attention of my right hon. Friend the Secretary of State for Transport.

George Young: Many of my right hon. and hon. Friends have strong views about the Government's proposals for police reform and have pressed the Government for a debate. On reflection, does he agree that it was ungenerous of him to describe such representations on behalf of our constituents as whingeing? Will he now answer the question that he has been asked twice by my hon. Friends the Member for Epsom and Ewell (Chris Grayling) and for Forest of Dean (Mr. Harper)? Why can we not have a debate on a substantive motion, or are the Government no longer interested in the expressed view of Parliament?

Geoff Hoon: The right hon. Member will know, given his careful attention to such matters, that the process is a long one. The early stages include the opportunity for voluntary amalgamations by police forces who judge that to be appropriate, followedin the event that there is no agreement on a way forwardby a longer period of consultation. In the spirit in which the issue has been raised in recent weeks, it is right that right hon. and hon. Members should have the opportunity to express their views in anticipation of that second stage, but obviously before any specific conclusions are reached, it would not be appropriate to have a debate on a substantive motion.

Fraser Kemp: In this new era of bipartisanship, will the Leader of the House join me and the Conservative Opposition in endorsing the views expressed by the hon. Member for Epsom and Ewell (Chris Grayling) on 15 November? He outlined the view that Opposition Front Benchers should divest themselves of any outside interests that conflict with their position. Will my right hon. Friend endorse that view, especially bearing in mind the concerns expressed by the Committee on Standards in Public Life?

Geoff Hoon: My hon. Friend makes an interesting suggestion and the issue will certainly be a test of bipartisanship. The hon. Member for Epsom and Ewell (Chris Grayling) has recently talked regularly of observing not only the spirit but the letter of the ministerial code, but does he believe that the spirit of the ministerial code should also apply to Opposition Front Benchers? If he wishes to encourage Ministers to observe the spirit of the code, it should apply equally to Opposition Front Benchers.

Andrew MacKay: Following the question asked by the hon. Member for Rochdale (Paul Rowen), may I press the Leader of the House for a ministerial statement once the coroner's inquest on those who died in the tsunami disaster is over? The report that has been published has shown significant failings in Thailand in particular, in contrast to Sri Lanka and Indonesia, where the FCO behaved well and did a great job. It is important for the victims, and so that the lessons can be learned, that we have a statementif not a debateimmediately after the coroner's report.

Geoff Hoon: The right hon. Gentleman raises the issue in a fair and proper way. He will know from his own previous ministerial experience that Governments always look carefully at any recommendations made by coroners arising out of the inquests that they conduct. I assure him that if the coroner does make specific recommendations, they will be considered in the same way as the recommendations of the recent report have been considered by the Government.

Tom Harris: Will my right hon. Friend allow an early debate on the importance to our national life of the print media? That would give the House an opportunity to express our concerns about the atrocious mismanagement of the Daily Record and Sunday Mail newspapers by their owners, Trinity Mirror Management, and the plans to downgrade the former from an excellent national newspaper to a regional newspaper by closing its Aberdeen and Dundee editorial offices.

Geoff Hoon: My hon. Friend has raised an important issue for his constituents and the country that he serves so well in this Parliament. I am sure that the message will be received by those whom he wants to hear it.

Pete Wishart: Surely this House is entitled to at least a statement on the whole issue of rendition flights, so that hon. Members can question Ministers on what they know about such flights. Today we learn that airport staff may be subject to prosecution if they service those flights. Significant legal opinion suggests that they may be aiding and abetting an illegal activity by doing so. Surely, given all the public concern, a Minister must come to the Dispatch Box and explain what he knows about the matter.

Geoff Hoon: As I made clear earlier, my right hon. Friend the Foreign Secretary has clearly set out not only the Government's position but that of the EU presidency, following the exchange of correspondence with the United States Secretary of State. There are a number of opportunities to raise those issues, and I am sure that the hon. Gentleman will take full advantage of them.

Diana Johnson: I have an important issue to raise with the Leader of the House about housekeeping matters. As a great tea drinker, I wonder whether he can explain why, when carrying out their duties during lengthy Standing Committee sittings, hon. Members are allowed to drink only water, not tea and coffee. Can he explain that to me?

Geoff Hoon: I have noticed in recent weeks that the range of my responsibilities has been expanding to include the post office, the bar downstairs and, now, the question of stimulants in Committees. That may well be a matter that I must draw to the attention of Mr. Speaker's distinguished Chairmen's Panel because I suspect that it is more in its province than mine.

Nigel Evans: That last question took the biscuit. [Hon. Members: Resign!] I have nothing to resign from.
	May I ask the Leader of the House for an early debate on British representation overseas? As he will know, this year and next year, a number of our high commissions, embassies and consulates will close, including those in Lesotho, Madagascar, Swaziland, Tonga, Vanuatu, Kiribati, Bahamas and a number of consulates in the United States and Germany. He must understand that lowering the British flag also lowers our influence and that the vacuum created will be filled by other countriesincluding, of course, China.

Geoff Hoon: I am aware of some restructuring of the way in which Britain organises its representation overseas. The hon. Gentleman is perhaps only telling the House half the story in the sense that, clearly, that representation is being extended in other parts of the world. At all stages, my right hon. Friend the Foreign Secretary, who is responsible for such matters, has sought to maintain the United Kingdom's considerable influence around the world. I am grateful to the hon. Gentleman for giving me the opportunity to pay tribute to those diplomats and civil servants who serve us so well overseas.

Julie Morgan: My right hon. Friend is aware that the Government of Wales Bill will be presented to the House this afternoon. I welcome the Bill, particularly as the Welsh Assembly will be given increased legislative powers, but it is disappointing that we do not yet have a date for the Second Reading. Can he give an indication of when the debate on Second Reading is likely to take place? Can he confirm whether the Bill's consideration in Committee will take place on the Floor of the House?

Geoff Hoon: I certainly hope that my hon. Friend will not have to wait too long for details of the Second Reading of that particularly important Bill for Wales. We will look at the appropriate rules to see how such major constitutional legislation should be dealt with properly.

Douglas Hogg: May I support the call by the hon. Member for Somerton and Frome (Mr. Heath) for an early debate, or at least a statement, on extraordinary rendition? It is a matter of very great concern if the United States is flying people across the world to be interrogated in private places beyond the reach of the law, whether local or international. That is a sort of mobile Guantanamo bay. It cannot be right. We need to know what is going on, and we need the opportunity to express our views.

Geoff Hoon: The right hon. and learned Gentleman is a distinguished Member. He knows full well that the United States Secretary of State has set out very clearly that what he is claiming is simply not the case: the United States is not involved in transporting people across the world for the purposes of torture. The United States rigorously observes the relevant US law and, indeed, the relevant international treaties.

Nigel Dodds: In Northern Ireland, we have been informed this morning that the prosecution has decided to adduce no evidence in the case against those responsible for the Stormont spy ring, which brought down the Northern Ireland Administration in 2002. That has caused great anxiety and consternation among the people of Northern Ireland this morning. May we have a statement or an early debate to indicate what are the reasons behind the public interest in refusing to pursue a case where the IRA and Sinn Fein were exposed as having been at the centre of a major spying operation against Government and security forces in Northern Ireland?

Geoff Hoon: The hon. Gentleman knows full well that those matters are determined by both an independent police force and, indeed, an independent prosecuting authority, and it simply would not be right for a Minister to comment on those independent decisions.

Alistair Burt: Like many colleagues, I have constituents who are in tears of frustration and distress at the workings of the tax credit systemincluding a woman who broke down when telling my wife that she had to receive bags of groceries because she has been asked to repay an overpayment so quickly. In view of that, would it not have been better for the Paymaster General to have come to the House on Monday to make a statement and listen to those concerns raised by right hon. and hon. Members, instead of placing a written statement in the Library?

Geoff Hoon: The hon. Gentleman is always fair and reasonable in his observations in the House, but my recollection is that the last Minister at the Dispatch Box was my right hon. Friend the Paymaster General. I am sure that he could have used his ingenuity to raise that issue during an hour of Treasury questions.

Alistair Burt: That was not the point.

Geoff Hoon: Nevertheless, before the hon. Gentleman gets too agitated, I recognise that there have been individual cases where the tax credit system has not worked as well as it should have done. That is one of the reasons why my right hon. Friend the Paymaster General has been looking very carefully at finding ways in which to improve the operation of the scheme. However, I emphasise that the overwhelming majority of people and families in receipt of tax credits have received that money successfully and that that has provided a major improvement in their standard of living and allowed many people to return to work, thus allowing families who would otherwise struggle financially to achieve a proper standard of living.

John Hayes: You, Mr. Speaker, will have been as shocked as I was when David Sherlock, the chief inspector of the adult learning inspectorate, condemned a 2 billion Government drive to improve basic literacy and numeracy levels as a depressing failure. Ministers have crowed that their skills for life programme was on target. Now we know that half the people included in the target number were 16 and 17-year-old college students who were already enrolled on basic literacy and numeracy courses. Will the Leader of the House arrange for a Minister to come to the House to explain why the scheme failed and why the Government claimed that it was on target when it was clearly far from that? That is a disgrace, and the Leader of the House should acknowledge it and do something about it.

Geoff Hoon: The hon. Gentleman picks on a disputed aspect of reports in relation to adult education. The Government have exceeded the targets that we set in relation to adult basic skills, with more than 1 million adults gaining a first qualification in language, literacy or numeracy. There are inevitably difficulties with all schemes, but I hope that, being fair-minded, he would recognise that, overall, those schemes have been remarkably successful in providing skills, opportunities, training and education to a large number of people who would otherwise not be able to join our work force.

Julian Lewis: May I ask the Leader of the House for an urgent statement on the differing availability of life-saving anti-cancer drugs in different parts of the country? My constituent, Mr. Brian Jago, is dying of cancer. His consultants say that Velcade, a new drug, could save his life and that probably nothing else could. If he lived in Cardiff or Edinburgh, we believe that the word of the consultants would be enough for him to be prescribed the drug. As he lives near Southampton, a district prescribing committee's permission is required, and that has not been given. May we have a statement about whose word should run in these mattersthat of a prescribing committee, or that of the consultants concerned with the welfare of the patients?

Geoff Hoon: If the hon. Gentleman will forgive me, I do not intend to be drawn into the circumstances of that particular patientobviously we are all concerned about his positionnor indeed of the particular drug. I accept that consistency across the country is necessary, and my right hon. Friend the Secretary of State for Health has had regard to that in relation to a number of high-profile cases. I hope that the hon. Gentleman will accept that that consistency must be determined by national standards, not least in relation to new drugs, as it is important for those who are likely to use them that the drugs are tested and satisfy stringent standards before being employed. I assure him that the Government are working hard to eliminate the type of discrepancy that he appears to be describing.

Crispin Blunt: The Leader of the House has described police restructuring as a long process. I have to tell him that it certainly does not look like that to the police forces and police authorities being restructured, because the decisions that they are being invited to take by 23 December do not include the status quo. May I reinforce calls for a debate on a substantive motion on 19 December, where the Government at least attempt to make the case for change in the House and to review the options presented to police authorities and forces up and down the country?

Geoff Hoon: I will not set out again the process points that I raised earlier, but the hon. Gentleman will know that the deadline of 23 December was set so as to allow voluntary amalgamation where police forces thought that it was in their interests to save costs, for example, by amalgamating backroom office functions and ensuring that there was a range of extra equipment across larger police organisations. That is all set out in the inspector's report, which I am sure that he has read in detail, and which is about a recommendation from senior police officers that there is a necessityan absolute requirementto improve the equipment and facilities available to our police forces across the country, and that must after all be in the interests of our constituents. I hope that the hon. Gentleman will look at the report and contribute to the debate on 19 December, when I shall take careful note of whether all the colleagues who called for the debate are in the Chamber to participate, as it is important that Members have the opportunity to set out their views. This process is in the interests of our constituents and to their benefit. That is why leading police officers have put it forward.

Michael Penning: Will the Leader of the House urgently find Government time to address the problems of identity fraud that are occurring throughout the country? Last year, it is estimated that 135,000 people had their identity stolen and had to pay up to 8,000 to have it legally returned. Will the right hon. Gentleman consider the matter urgently as it appears to threaten more than 1 million people?

Geoff Hoon: The Government share entirely the hon. Gentleman's concern about identity fraud. It is a problem for both the public sector and, crucially, the private sector, which is one of the reasons why the Government are bringing forward proposals for a system of identity cards. So on the next occasion that we debate the matter in the House, I look forward to the hon. Gentleman's support, otherwise he is simply raising issues with no intention of doing anything about them.

Eric Forth: Given that the Leader of the House expects us to be grovellingly grateful that he has finally consented to give us a debate on police restructuring, albeit in the last day or two before the Christmas recess, why is he afraid of having a substantive vote? Is it because he realises that it will expose yet again that a large number, if not a majority, of his Back Benchers are almost certainly against that absurd and dangerous proposal? Will he use his limited ingenuity to find some way even now of giving us a substantive vote on the issue on the Floor of the House, so that the Government can know, in numbers, how wrong they have got it?

Geoff Hoon: I am enormously relieved that the right hon. Gentleman has not succumbed to the charm offensive emanating from the Conservative Front Bench, although I am sure that all Members will join me in rejecting the suggestion made by the hon. Member for Buckingham (John Bercow) the other day, that the right hon. Gentleman is a Victor Meldrew figure. That was clearly an outrageous assertion that no one could possibly want to agree with, apart perhaps from the hon. Member for Buckingham, who no doubt thought better of it as soon as he had made it.
	I have set out the Government's decisions. We are having a debate on the matter before Christmas, which I thought Opposition Members were keen to do, and that will give all Members the opportunity to set out their strong views.

Greg Hands: Will the Leader of the House urgently investigate, or allow a debate on, the guidance and procedures for ministerial travel? The reason for that is that I have twice asked the Prime Minister when he last travelled on the London underground; like me, the Leader of the House will be aware that the matter is of great public interest. The 1997 code, item e, Public Accountability, states:
	Individual Ministers are responsible for justifying their actions and decisions to Parliament
	on the use of transport. It continued:
	  They will wish to be satisfied that their arrangements could be defended in public.
	It is most interesting that that was written by the Prime Minister, so when will he come to the House to answer my written and oral questions about when he last used the tube? That is a matter of great public interest.

Geoff Hoon: I am sure that it is a matter of great interest to the hon. Gentleman. My right hon. Friend the Prime Minister scrupulously observes the terms of the ministerial code and has always done so.

Philip Hollobone: Will the Leader of the House arrange for the Home Secretary to come to the House to make a statement on the Government's policy on illegal drugs and the reclassification of cannabis? Does he agree with the Home Secretary that having 4 oz of cannabis resin or 18 oz of cannabis leaf is an appropriate threshold between personal use and supply?

Geoff Hoon: The hon. Gentleman is referring to guidance issued for judgments made by individual prosecutors in individual cases as to how particular types of offence should be prosecuted. That is always a matter for the discretion of prosecutors and police officers. As I said in answer to an earlier question, it is not right that Ministers should make observations about that type of individual discretion. It is an essential part of our criminal justice process that such discretion lies in the hands of those who exercise it.

John Bercow: As my hon. Friend the shadow Leader of the House asked earlier, and as I have repeatedly requested, may we have an urgent debate in Government time on trade justice and freer trade? Given that meeting the millennium development goals on reducing maternal mortality and child mortality will cost $6 billion a year and that the richest nations on earth subsidise their agriculture to the tune of $6 billion a week, does the Leader of the House agree that a debate in the House would allow colleagues to argue passionatelyas I certainly would, if I caught your eye, Mr. Speakerthat reforming wholesale the socialist subsidy system in international trade is not only fiscally desirable but morally imperative?

Geoff Hoon: The hon. Gentleman regularly raises those issues with considerable effect, and in a way with which, generally, Ministers agree. The Government have taken precisely the type of action he describes. We negotiate vigorously in all international organisations to promote freer trade and justice. Indeed, we have to do so partly because of the failure of the previous Conservative Government to engage in that very process.

Hugh Robertson: The Leader of the House will be aware of the excitement engendered by the prospect of the 2012 Olympics and the stated aim of the British Olympic Association to move the UK from 10th to fourth in the medal table, so will he arrange an early debate on the funding of elite athletes? The BOA was expecting the announcement of an extra 25 million of funding in the Chancellor's pre-Budget report but that announcement was not forthcoming. Any delay will undoubtedly harm our chances at both the 2008 and the 2012 Olympics and the BOA described the decision as
	devastating news for British sport.

Geoff Hoon: It is important that we continue to support our elite athletes. The Government have put much financial backing behind them and, as a result, there were significant improvements in our results at the recent Olympics. The matter is obviously something for my right hon. Friend the Secretary of State for Culture, Media and Sport and I will ensure that it is drawn to her attention.

Peter Bone: I have a constituent who is seriously ill and has to undergo chemotherapy. She is also a witness in a court case. On three occasions, she has been required to attend court, and her relatives have come down from the north of England, and on three occasions the Prison Service has not delivered the prisoner to court. Will the Leader of the House arrange an urgent debate on Her Majesty's Prison Service?

Geoff Hoon: I will not comment on the specific case, but from my experiences and those of my constituents over the years, I know that there is a problem from time to time in ensuring that not only prisoners, but witnesses and all people involved in court cases, are brought to court on the right date. Nothing is worse, especially for victims, than cases that do not go ahead as scheduled. The Government have devoted an enormous amount of effort and energy to improving the procedures so that we can ensure that the experience suffered by the hon. Gentleman's constituent is not repeated.

Henry Bellingham: Has the Leader of the House had a chance to have a look at the Honours (Prevention of Abuses) Act 1925 and the Public Bodies Corrupt Practices Act 1889? Will he confirm that both those Acts are still on the statute book and have not been superseded by other legislation? If it were shown that a senior Government Minister in the Lords had fallen foul of those pieces of legislation, would the Leader of the House support calls for his dismissal from public office?

Geoff Hoon: I have not studied either of those pieces of legislation recently. Since I used to be paid for giving legal advice[Interruption.] Rather better paid than I am today, it is true. I do not know whether those Acts of Parliament are in force in their entirety or in part, but I assure the hon. Gentleman, as I assure the House, that Government Ministers observe all relevant legislation at all times.

Hercules Crash (Board of Inquiry)

John Reid: I am able to inform the House today of the findings of the Royal Air Force board of inquiry into the tragic crash of the RAF Hercules XV179 in Iraq on 30 January 2005. May I say at the beginning that I very much regret that some of the details appeared in two newspapers this morning? Some information was accurate, some was inaccurate and some was speculative. I apologise to you for that, Mr. Speaker. The only consolation is that the families had already been met and briefed before the reports appeared this morning.
	I first pay tribute to the 10 service personnel who tragically lost their lives aboard the Hercules while carrying out their duties: Flight Lieutenant David Stead, Flight Lieutenant Paul Pardoel, Flight Lieutenant Andrew Smith, Master Air Engineer Gary Nicholson, Flight Sergeant Mark Gibson, Chief Technician Richard Brown, Sergeant Robert O'Connor, Corporal David Williams, Lance Corporal Steven Jones and Squadron Leader Patrick Marshall. I am immensely proud of our armed forces and the work that they undertake on our behalf, as I am sure the whole House is. This was the biggest single loss of life in a single incident to enemy action in Iraq. Those 10 brave men lost their lives while working in support of the coalition operation in Iraq. We owe them, and all the other personnel who daily confront danger, our respect and gratitude.
	We must not forget the families and friends of those men. I am sure that the House will join me in offering our sympathy and deepest condolences. The Ministry of Defence, the Royal Air Force and RAF Lyneham, especially, continue to provide those families and friends with support while they come to terms with the tragedy. I recognise that the board of inquiry report will be painful reading for them, but I hope that they will take some comfort in finding answers to the many questions that arise after such an incident. I felt it important that the families were given time to prepare for the inevitable media interest, so they were briefed by an RAF team yesterday on the conclusions of the board of inquiry. Notwithstanding the prerogative of the House to be informed about such an event, I hope that everyone understands and supports the steps that were taken to inform the families first. They will be able to rely on the support of their friends and colleagues in the Army and the RAF, both formally and informally, for as long as they need it. I also pay tribute to RAF Lyneham. Its close community was hit very hard indeed by the tragedy, yet it managed to maintain its magnificent support for our deployed forces, both at the time of the crash and subsequently.
	Turning now to the report itself, I remind hon. Members that the purpose of a board of inquiry is to establish the circumstances of a crash and to learn lessons. It does not seek to apportion blame. The board of inquiry was convened the day after the event, on 31 January, and has considered a mass of evidence. The board established that, on 30 January 2005, an RAF Hercules C-130K took off from Baghdad at 13:24 Greenwich mean time en route to Balad, which is to the north of Baghdad, on a routine operational passenger and freight flight. Six minutes later, at 13:30 GMT, a radio message was received from the crew stating that the aircraft was on fire. At 13:55, the Hercules was confirmed as missingthat was the time of its expected arrival at Balad. At 14:15, the crash site was found by a US helicopter formation.
	On our behalf, US forces established a cordon around the crash scene and maintained it for as long as it was considered safe to do so. They did that at risk to themselves, and I am very grateful to them. The board of inquiry was convened and took on the task of recovering the bodies of the deceased and examining the aircraft wreckage for evidence. I commend the professionalism and dedication of all those involved in that difficult and harrowing work. The task had to be completed as swiftly as possible because of the ever-present threat of hostile attack. Much of the wreckage could not be retrieved in the time available before the cordon was lifted.
	Despite the loss of physical evidence, the lack of credible witnesses close to the crash site and the absence of an accident data recorder, the board of inquiry has nevertheless conducted a thorough and comprehensive investigation. The board examined all possible causes, eliminated those not supported by the available evidence and then thoroughly analysed the remainder until the most likely cause was identified. Throughout the process, the board was assisted by other agencies, including a senior air accident investigator from the airaccidents investigation branchthe AAIBof theDepartment for Transport. The experienced investigator independently investigated the crash in parallel with the board and his findings fully support those of the board. Furthermore, the AAIB investigator has stated that he was impressed by the approach adopted by the RAF team given the exceptionally difficult circumstances of the investigation.
	On 7 March, my predecessornow the Leader of the Housemade a written statement to the House about the inquiry's interim findings. The interim statement ruled out a number of possible causes for the crash. After exhaustive analysis, the board of inquiry has concluded that the aircraft crashed because it became uncontrollable after hostile ground-to-air fire caused the outboard right-hand wing to explode and separate from the aircraft. The crash was not survivable. The board identified three contributory factors: flying at low level in daylight made the aircraft vulnerable to some types of ground-to-air fire; the lack of a fuel tank inerting system in the wing fuel tank meant that it was possible for an explosive fuel-air mixture to develop; and the flow of intelligence information regarding ground-to-air fire was not as robust as it might have been.
	I remind the House that the purpose of the inquiry in identifying those factors is to learn for the future, rather than to apportion any blame. The board made a number of recommendations that we will study closely. We have, indeed, acted on many of them already. During the course of the inquiry, as the findings were emerging, the commander-in-chief of RAF Strike Command instigated a number of steps. C-130 tactics have been reviewed and low-level flying in daylight is now avoided wherever possible. However, it has not been prohibited as it can sometimes be the safest way of achieving an operational objective. We need to allow operational commanders in theatre the flexibility to choose the safest effective tactics to achieve their mission. The fitting of a fuel tank inerting system is being investigated as a matter of urgency and we have made changes to our ground-to-air fire reporting and dissemination system.
	Now that the board of inquiry has concluded, the full contents of the report will be thoroughly considered and acted on as appropriate. While we have to accept that any deployment of UK troops involves a degree of risksometimes considerable riskthe security of British servicemen and women deployed to Iraq and elsewhere remains our highest priority. We owe it to our personnel to do everything we can to ensure their safety.
	This is a very comprehensive report. A military aircraft accident summary will be placed in the Library of the House and on the internet site of the Ministry of Defence. In addition, a redacted version of the main body of the board of inquiry report will be available on our internet site. As the House will appreciate, the safety of our people is a principal consideration and we have rightly removed from the report any information that might endanger the security or capability of UK and coalition personnel or that might be of use to an enemy. That is the purpose of the redaction. For example, we have, for operational reasons, removed the detail of the exact weapon type used against the Hercules. To divulge that information might give the insurgents what they need to replicate the attack. It would be unhelpful to our forces and our coalition partners for the media to speculate on the weapon deployed. That is not a theoretical risk; it is very real. We have, however, tried to be as open as possible under all the circumstances.
	Our forces have made a significant contribution to the creation of the right conditions for wider peace and stability in Iraq. They have done, and continue to do, an excellent job in difficult conditions. Our deepest sympathies go out to those who have lost loved ones or who have been injured in operations. I can only speak in the highest terms of the qualities of all personnel who serve, and have served, therequalities that I know from my own visits and discussions with them.
	In conclusion, therefore, the board of inquiry into the crash of Hercules XV179 is now complete. I repeat my gratitude to the president of the board and his team for their painstaking work. I am sure that the House will join me once again in expressing deepest sympathies to the families and friends of the victims of this tragic incident. We must never forget, nor will we ever forget or underestimate the courage and professionalism of our service personnel in carrying out the tasks required of them.

Liam Fox: I thank the Secretary of State for his statement. We welcome the results of the inquiry and its thorough nature. We will study its conclusions in great detail. On behalf of the Opposition, may I again send our sympathy and condolences to the family and friends of those who were killed in this tragic incident?
	It is true that such tragedies are unavoidable in warfare, so we pay tribute to the bravery and professionalism of all our armed forces involved in the Iraq conflict. It is worth reiterating and remembering why they are there, and why they are making those sacrifices. They are doing so to help the people of Iraq achieve freedom, escape tyranny, develop the rule of law and live in a country that respects human rights. Those are noble ideals to fight or die for.
	I agree that it is not appropriate for the House to ask detailed operational questions that could compromise the safety of our troops, but the families of the crew, Hercules passengers and the British public more widely will have concerns with which the Secretary of State may wish to deal.
	There are four specific areas of concern. How many similar incidents were identified before this particular one involving British or American forces in Iraq or Afghanistan, and what changes were implemented as a result? On alterations to aircraft, the Secretary of State said that the fitting of a fuel tank inerting system was being looked at as a matter of urgency. What time scale does that involve? I entirely understand and agree that it would be inappropriatein fact, dangerousto speculate on the type of weaponry involved but, without giving details that might compromise the safety of our forces, can he tell us how widespread is the availability of such weaponry and what is its origin?
	Finally, the Secretary of State said that the flow of intelligence information on ground-to-air fire was not as robust as it could be. Does that mean that, on that occasion, intelligence about the specific threat in the area was available but not passed to the flight crew? That would indeed be a tragedy. Fatalities are inevitable in armed conflict, but the House looks to the Government to minimise the risk to our brave and professional armed forces.

John Reid: I thank the hon. Gentleman for his comments, and congratulate him on his new post. This is not the first time that we have shared views across the Dispatch Box, but I know of his commitment to his country and I am sure that that will be reflected in his commitment to the armed forces. I only regret that his first appearance at the Dispatch Box is marked by such a sombre subject. I thank him for the way in which he phrased his questions and for his recognition that we cannot be as open about everything as we are required to be on other subjects. I thank him, too, for the tributes that he paid to the armed forces and for his reminder of the purpose that brings us to Iraq, Afghanistan and other areas, as well as the high ideals that motivate that purpose.
	The hon. Gentleman asked several legitimate and important questions, including how many similar incidents had taken place. Ground-to-air fire incidents are quite frequent. In the previous 18 months or so in Iraq, there were over 800 such incidents, none of which resulted in a tragedy of these proportions. In a sense, therefore, there was an element of chance or bad luck on this occasion. That casts light on other questions, such as why an inerting system was not fitted to the C-130K. Until relatively recently, the Hercules was not routinely deployed to areas of such danger. It has been used on specific occasions, but it has not been routinely deployed as a transport plane, although that has become more frequent after 11 September and the events in Afghanistan and Iraq. There has been a wide range of incidents in which Hercules and other planes have been fired on, but never with this result until now. That is one of the reasons that we carry out such investigations. I will comment on two local incidents in the context of the hon. Gentleman's important last question.
	On the time scale for reviewing whether we should have a new system that would have assisted, that will be done as urgently as is possible. I discussed matters this morning with the Chief of the Air Staff and I know that some recommendations about the tactics have already been put in place and that urgent consideration will be given to whether measures should be fitted to the wings and fuel tanks to suppress the possibility of such an incident happening again.
	The RAF goes to great lengths to fit defensive suites of arrangements. The C-130K is the older version of the Hercules, but I can tell the hon. Gentleman that it has been updated already with such defensive suites as directional infrared counter-measures, missile approach warning systems, radar warning receivers, counter-measures dispensing systems, flight deck armour and a series of other modifications. I would not want anyone to believe that sufficient attention was not paid to these matters. A considerable range of defensive suites have been added, but this is the first example of such an incident happening. The RAF will therefore consider the matter urgently.
	The hon. Gentleman asked whether I could give any indication of the ground-to-air weaponry, without being specific. The indications are that a range of weaponry may have been used against the aircraft. That is precisely why I do not want to be specific about which one might have caused the explosion. Given that a range of weaponry was apparently used, the answer to his question about how widely available such weapons are in Iraq is that they are pretty widely availablethe types of weapon that were used, though not necessarily the type of weapon, which I do not want to indicate, that may perchance have been successful.
	The hon. Gentleman asked about the flow of information. What appears to have happened is that there were two attacks in roughly the same area that day against United States helicopters. They occurred within 1 km and 3 km of where the attack on the Hercules took place. This informationwhich was collated within about three hours of the flight, so there was not a great deal of time in any case to pass such information to the pilots and crew of the Herculesnevertheless did not reach them because the route of the Hercules was not  known to the Americans. There was a compartmentalisation of information as regards the Hercules precisely for security reasons. On a need-to-know basis, there was no need for the multinational forces outside our own preparations for the deployment of the Hercules to know of that.
	That was done for security reasons. With the benefit of hindsight, it would have been better in terms of risk had that compartmentalisation not taken place on that occasion. However, the House should understand why it was done at the time. Even if the information had been available to the crew and pilots before they took off, it may not have changed their decision to proceed. It may or may not have affected the route that they took, but in any case the balance of risk involved was such that, in general terms, the fewer people who know about a particular route, the smaller the risk is considered to be.
	It is obvious that the compartmentalisation meant to reduce the risk involves a risk. That is why one of the recommendations has already been acted upon. We have inserted extra British armed forces personnel into the flow of information in order to try to ensure that in future, while any such information is compartmentalised to the British, there will be a structure to convey it in circumstances similar to those in question.
	Finally, the hon. Gentleman referred to the tactic of low flying. As I said in my statement, that is being reviewed. Daylight low flying is not being prohibited, because there is a balance of risk. On a short journey, if the normal trajectory rising to a given height and then coming down constitutes almost all the activity, the exposure to certain types of ground-to-air fire becomes greater and far riskier than if the aircraft were flying at a low level, which is why on that occasion that method of travellow level covering flat groundwas chosen. Nevertheless, that can open up another risk, as we have seen. It re-emphasises the singular point that in an operational theatre such as Iraq, there is no risk-free flying, which is a testimony to the courage of our soldiers.

Bob Russell: I thank the Secretary of State for the advance copy of his statement. We on the Liberal Democrat Benches join him in his expressions of sympathy and condolence to the families of those who lost their lives in this tragic incident. The loss of any life in conflict is to be regretted, but he will know, as I do from my constituents' interests, that when several people from one military base die in a single incident the impact is much greater. I also join him in paying tribute to the military authorities in the UK for all the support they are giving to the families of those who lost their lives, and also to the American personnel in Iraq for all their support and bravery at the scene of the crash.
	The Secretary of State drew attention to the fact that the board of inquiry undertook an exhaustive analysis and produced a comprehensive report containing a number of recommendations. He mentioned that some of those had already been acted upon. It would not be appropriate to press any of those issues too strongly todaythere should be other ways of doing that away from the full glare of publicitybut can he give an assurance that, bearing in mind how exhaustive the analysis has been and how comprehensive the report is, all those recommendations will be implemented as soon as possible?

John Reid: Yes, I think that I can give the hon. Gentleman that assurance, with one little caveat. The people who are best placed to make the final decision about prioritisation of the recommendations are the Royal Air Force. I discussed the matter this morning with the Chief of the Air Staff, who will be handling all press inquiries today, as is appropriate on such a subject, rather than a politician. I know that he will give the matter the urgency that is required.
	I thank the hon. Gentleman for his tribute. We all recognise the effect of such an event on a local community, particularly RAF Lyneham. I had some experience of that when I went to the remembrance service, along with the hon. Member for North Wiltshire (Mr. Gray), who represents the area, and met some of the families there.
	Finally, I join the hon. Member for Colchester (Bob Russell) in thanking our United States allies and the servicemen and women who, despite the risk to themselves, not only discovered but protected the site of the wreckage for sufficient time to allow us to collect at least sufficient to make judgments on these matters. The hostility of the area, which is in what is known as the Sunni triangle, was such that we could not stay as long as we would like to have done, and there was some looting afterwards, but we recovered what needed to be recovered for the respect of the families and for the purposes of the inquiry.

James Gray: I had the privilege of standing on the windswept tarmac at RAF Lyneham as the 10 flag-draped coffins were brought off the Hercules. I spent the afternoon with the families and remain scarred by that experience. However, I know that the families will be glad that this announcement has been made before Christmas, which will be difficult for them, and I am sure that they will welcome the fact that the Secretary of State chose to brief them before today's statement, which was sensible and proper.
	I am particularly grateful that the report entirely exonerates the crew. In particular, the family of Flight Lieutenant Steady-Eddie, who was one of my constituents, will be glad that no blame has been attached to him. I am sure that the Secretary of State will join me in paying tribute not only to the bravery and professionalism of those who died, but the bravery and professionalism of all those at RAF Lyneham in my constituencythe first in and last out of every conflict.

John Reid: The hon. Gentleman's words are apposite. I know that he has provided assistance and support to families both in this specific case and over many years. I regret the fact that the board of inquiry had to report in the run-up to Christmas, which I know caused a great deal of pain. However, I also know that the families would not have had the board of inquiry unduly delayed and wanted their questions answered as openly and honestly as possible.
	Finally, I thank the hon. Gentleman for reinforcing the point that the crewthe pilots, the co-pilots and the one passengerwere courageous, skilled, highly committed, highly dedicated professional people and that no scintilla of blame has been apportioned to them. Once the incident occurred, the aeroplane became uncontrollableit could not have been controlled once it was hit, and the wing was severed after the explosion. I thank the hon. Gentleman for reinforcing that point. I am more than happy to repeat the central point that we have lost grievously from the service of the nation the skill, determination and courage of those who died.

Peter Bottomley: It is wise that the RAF and the MOD have not prohibited this kind of flying. It is important that the response is measured and we should not introduce so much protection that people cannot do what is required. Will the Secretary of State ensure that the flow of intelligence continues to go upwards towards those in the air? Although one can understand why a particular flight path is not given to those on the ground, the flow of information should be faster when incidents occur.
	In reviewing the consequences of the change to some of the responsibilities of ground defence from the RAF to the Army, will the Secretary of State consider the importance of thinking air? I hope that that is not a clich. People on the ground who are linking in with the RAF and other air forces must understand what people in the air need to know. Whether or not the change is a good idea, people on the ground need to understand the air environment.
	I think that the way in which the Secretary of State manages these announcements, which are difficult, is appreciated by the families and the House.

John Reid: I thank the hon. Gentleman for that comment and for both of his points. Although we are now aware of a nuance in the balance of risk, it does not mean that there is a risk-free route for such operations, which is why we have not reacted by immediately banning tactical low flying, even during the day. We are aware of the risk and will try to avoid low flying, but it is up to the commanders in theatre and the pilots themselves to decide whether they want to use that tactic. As I have said, there are risks in taking the normal trajectory on a short flight, which exposes people to greater risk for a greater part of such journeys.
	I agree with the hon. Gentleman's point about intelligence flow and the appreciation of aspects of intelligence by those who fly. While maintaining a degree of security of information to protect the operations of those who fly, we are trying to bridge the gap between the collection and dissemination of information to people who will appreciate what it means for their flying and for the risks attached to their flying. We are trying to improve the bridge between the collection of information, whether by ourselves or by others, and its dissemination to those who can judge it appropriately. Those skilled and trained professionals had a pre-deployment briefing and considered all the aspects of the information that was at their disposal. For reasons that I have already explained, the aspect about incidents in the area was not at their disposal.

Michael Penning: I thank the Secretary of State for today's statement. I pay tribute to our armed forces who are serving in Iraq and around the rest of the world for the fantastic professional work that they do on our behalf. Our love, best wishes, thoughts and prayers go to the families of the 10 servicemen whom we have sadly lost.
	I had honour of flying into Baghdad and Basra with the RAF shortly after the crash. The professionalism shown by the RAF was unbelievable and the Americans stood back in amazement at how the RAF had taken such a disaster on the chin and got on with their work, although the personnel were clearly very upset.
	I understand that we cannot discuss lots of details today for operational reasons and because of the sensitivities. Does the rest of the Hercules fleet, and particularly the C-130H and J aircraft, have fuel tank inerting systems, which would make our servicemen around the world safer? The Secretary of State may be considering fitting the C-130K with such a system.

John Reid: The hon. Gentleman's remarks to the families will be much appreciated, as will his recognition of the dangers of flying, which he has experienced personally. Some of us have had the privilege of flying with the RAF in what is for them a day-to-day, risk- filled theatre, such as Basra or Baghdad. Those of us who have put on body armour, put out the lights and flown at night at an angle of descent that is calculated to terrify most people outside the RAF while swerving, understand the risks inherent in such operations. We often forget that such flights are daily occurrences. That particular crew had already flown perhaps four times between Balad and Baghdad before the tragic incident occurred, and they had flown day-in, day-out since their deployment two or three weeks before the incident. Most of the crew were very experienced: between them, they had 19 operational deployments, so they were people who got on with the job as a matter of course and took those risks.
	The hon. Gentleman asked why a fire suppressant system was not fitted to the C-130 and what the position is on the other aircraft. As he knows, the K variant was first developed and built in the 1960s, when that technology was not available. Systems to upgrade the aircraft are now available and we are examining as a matter of urgency whether the technology can be successfully fitted to our aircraft. I must repeat my earlier point that, before the incident, the C-130 Hercules was not thought to be particularly vulnerable to that form of attack. We now know that it in certain circumstances it can be very vulnerable.
	We shall examine this as a matter of urgency. I merely point out that it is not always an easy thing to do. A data recorder, for instance, can be fitted relatively easily into a modern digitised cockpit, but the C-130K was built in the 1960s. Although we can put in a lot of defensive aids, it is not that easy to put in a data recorder where there are multi-faceted, sometimes clockwork, indicators and no central terminal from which to draw the information. There may be difficulties, but we are considering it as a matter of urgency.

Philip Hollobone: I should like to join in the tributes paid to those tragically killed in this incident. I am sure that the whole House appreciates the manner in which the Secretary of State has delivered this difficult statement. As a humble former paratrooper, I have every reason to appreciate the flying skills of all our Hercules aircrew, especially as most of them are at RAF Lyneham.
	My question concerns the search and rescue capability of our forces in theatre. I note from the statement that the last radio message was at 13.30 and that the crash site was not discovered until 45 minutes later. Is it the procedure that search and rescue missions are launched before aircraft are formally reported missing; and do British armed forces have their own independent search and rescue capability in theatre?

John Reid: Let me go through the chronology for the hon. Gentleman, and then I shall answer his question.
	The Hercules took off at 13:24 GMT. Iraqi local time was about three hours in advance, but I shall use GMT. Six minutes after taking off, the crew relayed the information that there was a fire on the plane. Some of this morning's press reports said that the plane had been enveloped in flames. That is not accurate, but, as we now know, there was a fire on board on the right-hand wing. That information was picked up not by an air traffic controller, but by other British forces. There was no communication subsequently. At 13:55 GMT, which was the expected arrival time at Balad, the aircraft was officially declared missing. There were a number of eyewitnesses, but they were a fair distancesome kilometresaway. In addition, there were United States forces in the area, who, after looking for the site, discovered it 20 minutes later at 14:15 GMT.
	I understand that that is the precise chronology. It has been explained to me that the message at 13:30 was not picked up by an air traffic controller, so there may have been a slight delay. I emphasise, however, that it is the strong and unanimous view of the board of inquiry, under Wing Commander John Reid, that following the incident the aeroplane was uncontrollable. Whatever happened after the time at which it was hit, the explosion separated the wing.
	Whatever had happened as regards search and rescue, assistance or aid would not have averted what ultimately, tragically, transpired. After that, there was nothing that the crew could do, highly skilled and highly trained though they were. They were put in a position whereby nothing would have prevented the plane crashing in the way that it did.

Points of Order

Liam Fox: On a point of order, Mr Deputy Speaker. Today's ruling by the Law Lords that information obtained by foreign countries through torture cannot be used in evidence in British courts is of enormous importance. Have Ministers made any requests to make a statement on this important issue? If not, will you use your good offices to impress upon the Government the importance of having it discussed in the House of Commons?

Mr. Deputy Speaker: I have no knowledge of such a statement being made, but the points that the right hon. Gentleman makes are now on the record, and no doubt everybody concerned will have noted them.

Nigel Dodds: On a point of order, Mr. Deputy Speaker. I wish to raise the issue of the increasing tendency of Northern Ireland Ministers to avoid coming to the House to make important policy announcements. I refer in particular to the written ministerial statement issued on Wednesday of this week by the Under-Secretary of State for Northern Ireland, the hon. Member for Basildon (Angela E. Smith), who is responsible for education in Northern Ireland. The announcement had already been made to the press and the public in Northern Ireland on the previous day, and it was reported at length in all the media, including the newspapers, on Wednesday morning. Is it not a grave discourtesy to Members of this House that a statement was not made on the day on which the announcement was made to the media and the public?

Mr. Deputy Speaker: The hon. Gentleman will know that Mr. Speaker takes a very strong line on these matters. Again, the points that he has made will be on the record, and I have no doubt that Mr. Speaker will note them and take them into account.

Peter Bone: On a point of order, Mr. Deputy Speaker. I should like to raise an issue of some importance. During Prime Minister's questions on 30 November, the Prime Minister indicated, as recorded in column 264 of the Official Report, that from the end of November there will be a six-month maximum waiting time for an NHS operation. On 1 December, 437 patients at my local hospital had been waiting for more than six months. This morning, I received a letter from the Secretary of State for Health in which she states that the maximum six-month wait is only a target and in any case does not come in until the end of 2005. Can I have some advice and guidance on how the Prime Minister's statement could be corrected?

Mr. Deputy Speaker: I am extremely grateful that one of the many things for which Deputy Speakers are not responsible is prime ministerial statements. The hon. Gentleman must challenge those in the usual way, and he must do the same with the statistics.

Michael Penning: On a point of order, Mr. Deputy Speaker. As I am sure you are aware, in the past few weeks there have been several false fire alarms in Portcullis House. On Tuesday, when three were going off, large numbers of members of staff, members of the public and Members had to leave the building through the front entrance. There are specialised fire doors there, and as a former fireman I know what should happen: the revolving doors should automatically swing open so that we can get people out as safely as possible. Those doors were inoperative on Tuesday. When I approached the excellent security staff, they told me that that has been reported several times but nothing has been done. Do we have to wait for people to be injured getting in and out before those doors are fixed?

Mr. Deputy Speaker: I understand the points that the hon. Gentleman makes, and they are of course serious. Again, they are now on the record and I have no doubt that the Serjeant at Arms will want to look into the matter to ensure that things are working as they should.

Angus MacNeil: On a point of order, Mr. Deputy Speaker. Has there been any notification from Ministers at the Department for Transport about the award of the Maritime and Coastguard Agency helicopter contracts? Substantial concerns have been expressed about the capabilities and suitability of the proposed replacement helicopters. These are key safety matters that are especially felt in my constituency. Will there be any occasion for a Minister to come to the House to make a statement so that Members may express their concerns?

Mr. Deputy Speaker: I have no knowledge of any proposed statement. In a sense, the hon. Gentleman's point is for business questions. Again, what he has said is on the record of the House.

BILL PRESENTED

Government of Wales Bill

Mr. Secretary Hain, supported by the Prime Minister, Mr. Secretary Prescott, Mr. Chancellor of the Exchequer, Secretary Margaret Beckett, Mr. Secretary Darling, Ms Secretary Hewitt, Mr. Secretary Clarke, Secretary Alan Johnson, Ms Harriet Harman and Nick Ainger, presented a Bill to make provision about the government of Wales: And the same was read the First time; and ordered to be read a Second time on Monday 12 December, and to be printed. Explanatory notes to be printed. [Bill 100].

ESTIMATES DAY
	  
	[1st Allotted Day]
	  
	VOTE ON ACCOUNT, 200607
	  
	Department of Health

[Relevant documents: The Fourth Report from the Health Committee, Session 200405, HC 42-I, on The Influence of the Pharmaceutical Industry; and the Government's response thereto, Cm 6655; and the Department of Health Departmental Report 2005, Cm 6524.]
	Motion made, and Question proposed,
	That, for the year ending with 31st March 2007, for expenditure by the Department of Health
	(1) resources, not exceeding 27,595,662,000, be authorised, on account, for use as set out in HC 465, and
	(2) a sum, not exceeding 26,808,818,000, be granted to Her Majesty out of the Consolidated Fund, on account, to meet the costs as so set out.[Claire Ward.]

Kevin Barron: First, I declare an interest in that I am currently a lay member of the General Medical Council and it is mentioned with other regulatory bodies and related associate bodies once in the report. I should put that on the record. This is my maiden speech as Chair of the Health Committee and the attendance resembles that for my maiden speech in 1983.
	The Committee's report on the influence of the pharmaceutical industry raised questions about how it is regulated and how it regulates itself. As hon. Members know, the pharmaceutical industry is the third most important United Kingdom industry economically after tourism and finance. The report acknowledged its valuable contribution to patient health and the economy. Although I shall mention some problems and some hon. Members might view the industry negatively, I shall put the debate in context by reminding hon. Members of the Health Committee's first conclusion in its report. Paragraph 336 states:
	The UK-based pharmaceutical industry is large, profitable and highly competitive; it has understandably been described as 'world class and a jewel in the crown of the UK economy'. The industry has an outstanding record in developing new medicines, and is a major source of funding of medical research. The industry's products include many life-saving and important drugs which greatly benefit many people and contribute substantially to national health.
	That is absolutely right. Although I am about to say, however, that paragraph places the industry in the context in which we should all view it: its contribution to the nation.
	However, the Committee had several concerns about medical research, the conduct of clinical trials, medicines marketing, the information provided to patients and prescribers and the independence of the regulatory system. Overriding themes of the report included the lack of transparency in medicines research and regulation, and the potential effect of that on patient safety.

Philip Hollobone: I congratulate the right hon. Gentleman on his introductory remarks. He is absolutely right to place the debate in the context of the world-wide demand for pharmaceutical produces. Is not it the case that Britain can hold its head up and be proud of its contribution to improving people's health around the world?

Kevin Barron: That is correctand in doing so, the amount of money that the industry makes in exporting around the world substantially enhances our economy. That is good for all.
	Patient safety is paramount in the use of drugs in this country and it goes to the heart of the Committee's report. If a patient is prescribed one drug rather than another, similar drug, the negative effect on the patient is likely to be minimal. If, however, a patient is prescribed a drug that is linked with negative physical effects of which the doctor is not aware, the results may be far more serious. The regulators, industry and health care professionals have a role to play in ensuring that potential side effects are picked up early in drug testing, made known to doctors and monitored after licensing.
	The Committee highlighted the need for better reporting of adverse drug reactions or ADRs. I am pleased that the Department is addressing that. The yellow card system of reporting ADRs is now being rolled out to include patients and all health care professionals, such as nurses, pharmacists, health visitors etc. Previously, only doctors could report suspected drug side effects. Pilot schemes were already running at the time the report was published and final systems will be in place by 2006. A new IT system will improve the detection of signals of a problem with a particular medicine.
	Drug-induced illness was recognised by the Government as a serious issue in human and economic terms. The Department of Health and the Medicines and Healthcare products Regulatory Agency have commissioned research to determine the frequency of   medical errors. According to a recent National Audit Office study, medication errors are the second most common patient incident in the national health service.

Peter Bone: It has come to light that one of the problems is repeat prescription provision, especially in the care of the elderly, particularly those with dementia. Although they initially get the right drugs, the repeat prescriptions do not necessarily help them and, indeed, have a negative effect. There is no proper procedure for reviewing those prescriptions at least every six months.

Kevin Barron: Repeat prescriptions are sometimes numerically limited so that one has one, four or five out of six. After that, it is doctors' clinical responsibility to ensure that they see the patient before any further prescribing of the drug. However, what happens in the real world is not always consistent with that. Occasionally, that is at great cost to the individual concerned, but it is always at great cost to everyone because safety incidents cost the NHS approximately 2 billion a year in bed days in our acute sector. They are problems for clinicians and everyone.

Paul Flynn: The university of Liverpool recently reported that there are at least 10,000 fatal adverse reactions to drugs in this country. Is not it therefore extraordinary that the Government's response to the report does not mention Vioxxthe most recent scandalor Seroxat?

Kevin Barron: I am not aware of the Liverpool report, but my hon. Friend is right about what the Government mention. However, they have been examining the mechanisms around the issues, and I shall consider that later.
	The Committee recommended improved post-marketing surveillance beyond ADR reporting. It suggested that more trials of licensed drugs be conducted in real-life situations, but that is not mentioned in the Government's response.
	Post-marketing surveillance by the MHRA will be strengthened under a planned reorganisation of the agency. The Government reject the recommendation that drug surveillance be carried out independently of the agency. They say that such a system would
	impede the continuous examination of the risk: benefit balance
	of the marketed drug. I am sure that the Under-Secretary of State for Health, my hon. Friend the Member for Birmingham, Hodge Hill (Mr. Byrne), knows that members of the Health Committee will be watching what takes place.
	I should like to consider transparency.

Brian Iddon: Does my right hon. Friend agree that counterfeit drugs are an increasing problem and that many counterfeit drugs are introduced into our country via parallel trading? Does he also agree that legislation is needed to combat the introduction of counterfeit drugs into the market? Unfortunately the drugs that are being counterfeited are those that are most commonly usedobviously, they are the best sellers, which give the most profit to the counterfeiter.

Kevin Barron: I agree with my hon. Friend. Although the report did not look into the matter in detail, parallel trade and counterfeiting is a problem, not only for the market but for safety and efficacy. It is important that those issues are considered.

Andrew Lansley: Does the right hon. Gentleman agree that we should not assume that randomised control trials designed to establish the efficacy of drugs can always provide the same degree of assurance on a drug's safety? Should not particular importance therefore be attached to the capture of data from whole populations after licensing, to establish the safety of the drug? It would be impractical to undertake that kind of evidence gathering from a substantial population before licensing.

Kevin Barron: I agree with the hon. Gentleman. There should be more ongoing studies to establish what happens after a drug enters the marketplace, and to determine which drugs are being used. Over the past two weeks, the Health Committee has been looking into expenditure levels in the national health service. The Secretary of State and various civil servants have given evidence to the Committee, and we discovered that we often do not know which families of drugs are being prescribed. We need that information to determine certain interactions, perhaps with public health promotion or with people getting assistance in the acute sector. We need to determine whether any great changes have taken place in the level of use of certain families of drugs over the years. We need a big national picture of the use of those drugs in society, because this relates to the money that we, as taxpayers, spendand the taxpayers' money that the Department of Health spendsto try to improve the nation's health. I do not know whether there are any simple correlations in this regard, but when we were taking evidence the other week, we felt that we ought to be able to get an answer to that question.

Andrew Lansley: This is an interesting point, and I hope that the Minister will tell us more about electronic prescribing and about the conversion of the Prescription Pricing Authority on to an electronic basis. That should, in theory, allow us to extract much more of the data that the right hon. Gentleman describes. However, although the transfer to electronic prescribing has increased, we are still achieving only a tiny fraction of the amount that was intended. By this stage, we were expecting to have pretty much an entirely electronic system, from the doctor's screen right through to reimbursement through the PPA.

Kevin Barron: I do not disagree with the hon. Gentleman, but I shall not be tempted to discuss information technology in any part of the public sectoror the private sector, for that matterbecause it has its own history. We have debated the issue in the past, and we will no doubt do so again.

Paul Flynn: A serious situation has just been revealed in a report by the university of Sussex, which shows that we have been much too ready to license drugs in this country, compared with the United States. Between 1971 and 1992, nine drugs were withdrawn in the United States because they had serious adverse effects, whereas the figure in this country was 24. In our rush to put drugs on to the market for the benefit of the pharmaceutical companies, we are conducting experiments with those drugs and using the public as guinea pigs, and those guinea pigs often do not survive the experiments.

Kevin Barron: My hon. Friend will have to forgive me, because I disagree with parts of what he has just said. I know that he has taken a great interest in the pharmaceutical industry for many years, but I do not agree with him on this issue. Proper licensing arrangements are in place. Yes, it is true that issues such as the withdrawal of Vioxx come around now and again, but patient safety was one of the first subjects emanating from the report that I raised in this debate. The House must understand that I was not on the Health Committee when the investigation took place or when the report was published, although I did play a role in trying to get the Government's response a bit earlier, in view of their delay in providing it.

Paul Flynn: I want to give the House a clear example of the disastrous failure of our regulatory system. The   Food and Drug Administration in America has claimed that there were 144,000 cases of heart attacks and strokes due to the use of Vioxx. However, in answer to a parliamentary question asking how many bad reactions had been discovered here under the yellow card system, I was told that there were never more than half a dozen a year, and that they amounted to no more than 12. There is evidence of 4 million prescriptions for medicines of this type being prescribed, and if America had not discovered the terrible, fatal side-effects of Vioxx, we would still be using it, and British patients would still be being killed by it.

Kevin Barron: Vioxx is an issue for everyone here, and the Health Committee asked for a public inquiry into the matter, saying that when a drug is withdrawn in the way that Vioxx was, there should be a public inquiry. The Government did not agree, and I have to say that I have some sympathy with the Government on that. However, the public should have more information on the way in which the drug was licensed and came into use, so that they can be satisfied that we understand the issues surrounding it. My hon. Friend mentioned half a dozen cases. He will be aware that there is the potential for litigation on this matter either in this country or the United States. Reports in The Lancet have put the number of cases in this country of people who have been affected long-term in relation to taking Vioxx at far higher than half a dozen. Perhaps my hon. Friend the Minister will comment on this when he speaks later in the debate.
	The lack of transparency in the MHRA and the industry means that health care professionals do not always have all the information that they need to make appropriate prescribing decisions. The report welcomed the introduction of a register for clinical trials, which will allow professionals and the general public to access information about the development of drugs. The Committee's proposal for maintenance of the register by an entirely independent body was rejected, as was the recommendation that information regarding clinical trials be available at drug launch, so that prescribers could access information during the period when the promotion of a new medicine was at its most concentrated. The Government believe that the publication of such trials within one year of launch is appropriate.
	The Government's response reiterates the importance of a close relationship between the Government and the pharmaceutical industry, citing as a reason the need to ensure transparency in the way in which medicines are brought to the public. The response stresses the role of the ministerial industry strategy groupthe MISGin this respect. Importantly, the response agrees that
	there is a need to look at whether there is a safer way of introducing new drugs,
	and this is one of the aspects that will be considered by the MISG. I hope that, in doing so, it will consider the issues around Vioxx that my hon. Friend mentioned.
	Corrective statements will not be issued in every case of a breach of legislation, as was recommended by the Committee. However, the MHRA is considering publishing the correspondence with companies relating to the promotion of medicines. The agency will also publish an annual advertising regulations outcome report. Contrary to the Committee's recommendation, information received by the MHRA will remain confidential until a licensing decision has been made. However, upcoming legislation will require a public assessment report of a medicine's licensing history to be published shortly after a licence is granted. The MHRA has undertaken to publish assessment reports for licence renewals and safety update reports. Such safety reports will also be issued more frequently.
	One of the Committee's main recommendations was for a large-scale, independent review of the MHRA to be conducted. The suggested governing principles included the agency's need for independence from the Government and the industry, greater transparency, greater proactiveness in post-marketing surveillance, the prioritisation of new marketing applications, and the inclusion of lay members in policy-making decisions.
	That recommendation was rejected by the Government, although they stated, on page 18 of their response, that perhaps a four-yearly review of the operations of the MHRA should take place. If that were to happen, the terms of reference would remain to be decided. I remind the House that the terms of reference should consider methodology, timing and other issues. If the Government adopt that approach, as I think they should, it would be useful if there were a parliamentary input into exactly what the terms of reference should be, either on the Floor of the House or at least from the Health Committee. I am sure that members of the Committee would be more than happy to consider the issue.
	Both the report and the response stressed the importance of research and development for patients and the economy, and the need to maintain levels of investment by drug companies in the United Kingdom. However, the Government agreed with the Committee that there were occasional deficiencies in the design and conduct of clinical trials. Poorly designed trials have significant consequences for patient safety, as is shown by the tragic consequences of widespread prescription of the anti-arthritis drug Vioxx, mentioned by my hon. Friend the Member for Newport, West (Paul Flynn).

Adam Afriyie: I thank the right hon. Gentleman for being so generous in giving way.
	It seems that the National Institute for Health and Clinical Excellence must rely on published evidence. In many cases, evidence of a faulty trial or certain sets of data are not published. Does that cause the right hon. Gentleman as much concern as it causes me?

Kevin Barron: Yes, it does. It should concern us all, and it should concern the pharmaceutical industry more than any of us, because it is directly responsible for ensuring that we have as much information as is necessary.
	The Committee recommended closer working between the MHRA and the industry to ensure that trial design benefits patients. No changes or additional work by the MHRA to improve the design of trials to reflect clinical improvements is suggested in the report, which I think is a shame. Guidance on
	the type of clinical trial required for marketing authorisation
	is said to be already in place, but that does not apply to guidance on the types of trial likely to prove therapeutic gain. That is one of the issues raised by the hon. Member for Windsor (Adam Afriyie). No additional funding for NICE to address the issue has been agreed, and the report does not mention changes in the way in which research ethics committees review and approve clinical trials. I think that that is wrong. As I have said, the issues should concern us all. On the few occasions that such matters do come into the public domain and drugs are removed from the market, we should establish why that has happened. When drugs come on to the market, we should do our best to ensure that that is dealt with as safely as possible.
	The report highlights the problem of me-too drugsmedicines that add little to the clinical effects of chemically similar drugs that are already on the market. The Government recognise the problem, and the response states that additional work by the National Prescribing Centre may be considered to address it. The Government agree with the Committee that impediments to generic drugs entering the market should be prevented, and will consider an initiative to investigate the problem.

Andrew Lansley: Does the right hon. Gentleman agree that we must be careful about criticising what are described as me-too drugs? They may allow incremental improvements in terms of efficacy or dosage. In the industrial context, even where branded drugs have a degree of intellectual property protection, they can disclose further evidence of the benefits of competition, and give us a handle on what would be happening in a more competitive market.
	We need not rely on the National Prescribing Centre as a mechanism. We can help NICE to advance the point at which it undertakes multi-technology appraisals, and examine the cost-effectiveness for the NHS of classes of drugs taken together.

Kevin Barron: I do not disagree with that, and I do not think that anyone else would either, although obviously there is the issue of drugs coming on to the market and being patented. I am sure that the issue is considered, but not in the detail that the Committee would have liked. I am pleased that some agreement has been established.
	The report also raised the issue of ghost-writing, which relates to cases in which well-known doctors or academics put their names to research articles that they did not write. They may not even have seen the data referred to. The practice was criticised in the report, and has recently received media coverage as well. The evidence taken by the Committee was led in part by the Royal College of Psychiatrists, which submitted written evidence of its concern. Last week I received a letter from its president, Professor Sheila Hollins, who wrote:
	I know that the Health Select Committee, in its report on the influence of the pharmaceutical industry, was very concerned about the failure of drug companies to publish all their findings regarding the efficacy and safety of drugs. This was also the most important issue raised in our submission to the Committee. I am aware that this situation is unlikely to have significantly changed; and many members of this college have grave concerns about the impact of selective publishing upon the trust placed in the pharmaceutical industry by patients and professionals alike.
	I have a great deal of trust in the pharmaceutical industry, but I hope that my hon. Friend the Minister will address the issuehighlighted by a recent caseat some stage, if not this afternoon.
	The Government's response makes no mention of ghost-writing, and does not respond to the Committee's recommendation that the industry adhere to guidance set out to ensure that publications are produced in a responsible and ethical manner. Ghost-writing is widely thought to be standard practice in the pharmaceutical industry, as the Committee was told. As I have said, I was not a member at that time. However, witnesses from the industry denied that that was the case.
	In the past few months, the media have reported a number of cases of so-called ghost-writing. In the past few days, The Times Higher Education Supplement and The Observer have reported a case in which researchers from Sheffield university, collaborating with a drug company, published findings without full access to the trial data. I do not know all the details, but I have seen the media coverage and I have received e-mails from one of the parties. I should like my hon. Friend to examine the position.
	Paragraph 199 of the report states:
	Sir Ian Chalmers recommended that the industry adhere to guidelines set out in Good Publication Practice for Pharmaceutical Companies
	that was published in 2003, in Current Medical Research and Opinion
	that aim to ensure that publications are produced in a responsible and ethical manner. They include the need to publish results of all clinical trials of marketed products, and to report them in a balanced and objective manner. Authors should all have access to the statistical reports and data supplementing each publication. These guidelines are clear on the subject of authorship and the role of professional medical writers.
	The guidelines are then listed.
	I hope that the whole industry, all academics and all clinicians adhere strictly to those guidelines. It does not matter to me at this stage whether they are statutory, but I suspect that if they are not adhered to at some time in the future they may become statutory. We cannot require our clinicians, who work so hard both in hospitals and in primary care, to read everything, or cross-question on everything, that enters their domain. They need information about new drugs coming on to the market and about what they should and should not prescribe. Academics' reports, wherever they are published, should reflect accurately what has happened when a drug has come on to the market.
	I would like to move on to another aspect of the reportits coverage of NICE, which the hon. Member for Windsor mentioned a few moments ago. The Select Committee recommended that NICE receive additional funding in order to issue guidance more quickly. Indeed, it recommended increased funding in order to allow NICE to evaluate more medicines more quickly and argued that the consequent improvement in prescribing standards should make NICE cost-effective.
	NICE was criticised during the inquiry not for the actual work that it doesI do not think that anyone can criticise NICE for the brilliant work that it doesbut in respect of the speed at which it issues guidance. Doctors, patients and the industry agreed that the wait for guidance to be issued was unacceptable. We have all heard the comment about the phenomenon known as NICE blight, whereby the NHS will not provide a treatment until it has been approved by the institute. Several witnesses who gave evidence to the Committee referred to it. The more thorough an appraisal, of course, the longer the delay. I spoke earlier about getting the balance right between safety and efficacy, and it is important to recognise that in certain circumstances there can be delays. It is a delicate area, as we must all accept.
	The Government have recently looked into the new fast-track system of assessment. Fortuitously, I received a letter from the Department this morning. I had written on behalf of a constituent who had contacted me on 15 November about a life-saving drug called Velcade. I received a reply from the Minister of State, Department of Health, my right hon. Friend the Member for Liverpool, Wavertree (Jane Kennedy), which says:
	A new, rapid process for assessing drugs and other treatments will be launched by NICE to sit alongside its standard process. The process will not be used for all appraisals but will be used initially to produce faster guidance on certain life-saving drugs used in a single disease or condition. NICE's new shorter appraisal process is designed to retain the integrity of its existing methodology but there is scope for NICE appraisals to take a longer track if the complexity of the topic warrants it. Publication of NICE guidance on specific drugs will be brought forward by between 615 months from the time originally planned. Work is starting immediately on five products, including Velcade
	as my constituent will be pleased to hear. It continues:
	The first guidance developed using the new process is expected to appear as early as June 2006.
	I am very pleased about that, as it appears that the Government have seized on the issue. It is difficult on occasions to achieve the right balance, but hon. Members will know that the coverage of drug promotion in the media brings a great deal of pressure on NICE, on clinicians and, indeed, on Ministers. We have seen clear examples of that in recent weeks.
	It is a difficult area to balance, but there is an issue about the funding of NICE that the Government did not properly address. It is important to consider how much research it is reasonable for NICE to conduct annually. Somewhere between 200 and 300 medicines and drugs receive a licence every year in this country, and I believe that NICE looks into between 30 and 40 of them. The new process may allow NICE to investigate more. No one would expect all licensed drugs to go through the NICE process, but it would be good if we could get rid of the NICE blight. If that is the intention of the new appraisal process, I am pleased to support it.
	The report also suggested that NICE extend its role to give advice to industry on the design of clinical trials likely to yield clear results and to be useful in the production of NICE guidance. That issue was not covered in the Government's response, but I believe that it is a very good idea. On a daily basis in clinical trials, consultants and doctors throughout the country, working alongside the pharmaceutical industry, give advice about what is happening within the NHS. We do not know much about it, as it is not often discussed, but most drugs are developed in situ in our hospitals and sometimes in the primary sector. The more collaborative we can make the process, the better. We want people to have confidence in NICE and what it does, so advice from NICE about what is going on in respect of guidelines for treatment, drugs and care is also important. Clearly, the Government and the pharmaceutical industry should look further into that in future.
	I have brought up many issues in my speech and I am sure that hon. Members who were Select Committee members at the time will have further issues to debate. The investigation into the pharmaceutical industrythe first since 1914was wide ranging. I am pleased that the Government responded well in certain respects, but they could have made a fuller response in other respects. My final commentto the Minister, hon. Members or anyone else who is listening to or reading the debateis that the Health Committee will be looking into the developments emerging from this report and response for many years to come.

Julia Goldsworthy: I should like to declare an interest in that I have a slight cold at the moment, so I am probably benefiting from some pharmaceutical products.
	Today's debate comes off the back of a report from the Health Committee that was released in 2005just ahead of the general election, but before the right hon. Member for Rother Valley (Mr. Barron) became Chairman of the Select Committee and before my time in Parliament. Although the report listed a series of concerns and made a series of recommendations, it carefully highlighted the importance of the pharmaceutical industry to our economy. That importance is well understood by Members, because, in some cases, literally thousands of their constituents are employed by that industry. We know that the pharmaceutical industry's contribution to the nation's economy is ranked third only to tourism and finance. We also know that investment made by UK pharmaceutical companies represents 65 per cent. of health-related research and development in the UK, and 10 per cent. of global research and development expenditure.
	The industry makes such a marked contribution to the economy because the development and production of drugs has truly revolutionised our lives. The discovery, development and use of drugs has had a revolutionary effect on our lifestyle, life expectancy and our ability to cure and to cope with illness. About 650 million prescriptions are issued each year at a cost of 7 billion to the NHS. Today, it is increasingly believedI share that beliefthat for every ill we suffer, there is a pill that we can pop to cure it.
	Despite recognising the important and revolutionary contribution of the pharmaceutical industry, the report highlighted a series of concerns that ultimately stem from the fact that certain issues have been ignored for nearly 100 years and from the imbalanced approach that the Government have adopted to the pharmaceutical industry on the one side and the patient on the other.
	As we have already heard, allegations were made about badly designed and biased clinical trialstrials biased towards showing drugs in the best possible light. There is evidence of selective publication of evidence relating to those trials, in which the negative evidence was not made public or full data sets were not published. Allegations were also made about ghost-writing, with the names of third-party so-called independent academics being added to papers not authored by them. Sometimes their names were added, but they did not have full access to the full data sets on which the reports were based.
	Finally, the report highlighted the ever-increasing intensity of the promotion of new drugs that provides incentives for prescribers that are totally unrelated to health outcomes. Press coverage referred to incentives that ranged from winning an iPod if a drug is prescribed to entertaining nurses and doctors at very nice hotels or restaurants. There were justifiable concerns that such practices could end up having a negative impact on patient outcomes.
	One problem is the fact that NICE licensing relies on published evidence, but we have already seen that the full data sets are not always published. If negative evidence is not made available, surely NICE is being constrained in its ability to make evidence-based decisions. There are concerns that the lack of an evidence base could lead to the unsafe use of drugs, and that the level of brand awareness has resulted in extension beyond appropriate prescription because of pressures from patients and prescribers.
	In response to these concerns, the Select Committee recommendations centred around the need for transparency in the licensing process, for greater independence of assessment, and for greater research into the potentially adverse effects of prescribed drugs, given that up to 5 per cent. of hospital admissions are the result of adverse reaction to drugs. Its final recommendation was as follows:
	In view of the failings of the MHRA, we recommend a fundamental review of the organisation in order to ensure that safe and effective medicines, with necessary prescribing constraints, are licensed.
	So the Committee felt that there needs to be much greater balance between promoting the interests of the pharmaceutical industry, and promoting the health of the public and the effectiveness of the NHS. It was felt that those recommendations would help to redress that imbalance.
	Unfortunately, in many respects the Government's response, published in September this year, reflects the perpetuation of this imbalance. Many of the recommendations were not acted on, and in many cases the justification given was that the Government did not recognise or acknowledge the problem identified by the Health Committee report. They said that current guidelines and measures are already, or are about to be put, in place to deal with these problems. The result is that the fundamental balance between the patient and the industry has not shifted, although some welcome concessions have been made to improve the MRHA's marketing material.
	The industry itself has also sought to improve its practices. The Association of the British Pharmaceutical Industry recently issued new guidelines to help encourage best practice. These are voluntary guidelines that represent a gold standard; they are not backed up by the law. While the ultimate sanction for breaking the code is expulsion from the ABPI, that has never happened. The board has never required a company to publish a corrective statement for a breach of those guidelines.
	Some of these guidelines are rather vague. For example, although delegates sponsored by companies to attend meetings can travel there and back only on economy flights and must not stay in lavish accommodation, it is not clear what is meant by that or what the extent of their stay will be. Of course, many companies will follow these guidelines for reasons of reputation, but the fact is that if they are voluntary, they ultimately lack teeth.
	Recent evidence in the press indicates that such problems are still arising. However, they are being dealt with by the MRHA on a case-by-case basis, without any significant strategic or systemic changes being made. A piece in last Sunday's edition of The Observer refers to allegations of ghost-writing; the academic concerned apparently did not have full access to the data sets that the report put his name to. As I have said before, evidence emerged last month of perks for prescribers. They could win an iPod if they prescribed gum disease medication, and some doctors and nurses were entertained at the Groucho club.

Charles Walker: Am I not right in thinking that the new ABPI code of conduct specifically limits the maximum value of these awards and gifts to 6 excluding VAT?

Julia Goldsworthy: I was not aware of that. I am not sure how the ABPI could provide flights to and from seminars at that low value, even given the existence of some very low-cost carriers. There may still be some devil in the detail and of course this code remains voluntary.

Paul Flynn: The new code of practice is entirely cosmetic and has been described by the British Medical Association as lacking teeth. The Drug and Therapeutics Bulletin describes it as fundamentally weak in all respects. It is purely window-dressing to hide the drugs industry's continuing close collaboration with the MHRA, which has been so detrimental to patients.

Julia Goldsworthy: I recognise the hon. Gentleman's concerns, but of course, although the problems associated with patient safety and access to drugs can in some respects be dealt with through improved regulation of the pharmaceutical industry, that is not the sole determinant. It is clear that the Government's behaviour has had a significant impact, and stories in the media have a fundamental impact on the public's awareness of drugs. Moreover, the Government have a major influence on the ability to get new drugs to patients quickly.
	We have heard much this afternoon about NICEblight and the delays in the licensing programme, but to what extent are those delays due to NICE? My hon. Friend the Member for Sutton and Cheam (Mr. Burstow) recently tabled written parliamentary questions on this issue, and the answers show that it takes the Government nine to 10 months to produce the list of drugs that is subsequently sent to NICE for licensing approval. That is another part of the delay in getting drugs to patients who may need them as quickly as possible. I should be grateful if the Minister explained the reasons for this delay and what measures his Department are implementing to speed up the process.
	There is also the apparently contradictory position whereby drugs need to be licensed by NICE before they become widely available, yet in some casessuch as the recent and well-known one involving Herceptinstatements have been made implying that there should be widespread uptake before the licensing process has been completed. What assessment has the Minister's Department made of the immediate and long-term financial implications of making such drugs available? On Herceptin, we know that it is not a question simply of the cost of the drug; there are also costs associated with echocardiograms and ongoing monitoring. Herceptin will of course make a huge difference to some women with early-stage breast cancer, but how do the Government envisage that these costs should be met, given the existing pressures on many budgets? The cost of such drugs is only rising, so what is the long-term sustainability of their prescription? There is a real concern that post-2008, when the increase in NHS funding tails off, funding for many such drugs will experience a hard landing.
	Finally, in contrast to moves to increase the transparency of the data

Andrew Lansley: We have not heard the hon. Lady's proposal on Herceptin. On the face of it, Herceptin has significant beneficial effects as disclosed in clinical trials, but a licence application has yet to be made in respect of it. In France, there is explicit recognition that in certain circumstances, certain drugs can provisionally be made available for use, pending licensing and approval. Is that not the right mechanism? If not, what does the hon. Lady propose?

Julia Goldsworthy: It is of course important to make such drugs available as quickly as possible, but certain systemic problems have been highlighted, such as NICE blight. We need to take steps to prevent such exceptions from having to be made.
	Finally, given moves to increase the transparency of data relating to clinical trials, why do negotiations with the Treasury on the pharmaceutical price regulation scheme take place in such deep secrecy? Do the Department plan to make this process more open?
	I turn finally to other potential dangers and difficulties for patients

Adam Afriyie: I thank the hon. Lady for giving way before she moves to her final, final point. She focused on costs, but does she agree that although the work that NICE does is very important, it is also important that it be done quickly? In many cases, it is a matter of life and death as to whether or not a particular drug gets to the patient quickly. Does she also share my concern at the fact that, rather than the budget increasing, it has just been reduced by 3.5 million? That will surely cause more problems than even the difficulties relating to Herceptin.

Julia Goldsworthy: I think that the hon. Gentleman is right. What will happen once the funding structure changes and what the impact will be on the availability of certain drugs are important issues to consider.
	Reference has already been made to the shift to cheaper generic drugs and the practice of drugs bought in other EU countries being repackaged and relabelled through parallel trading. In both cases, I understand that while the medication itself remains the sameI have discussed the matter with an hon. Friend who is a pharmacistexcipients such as additives for colour might change or vary in the medication. That can cause unfortunate side effects, particularly in the case of epilepsy drugs.

Brian Iddon: I must challenge that statement. Evidence was given at a meeting in the House last night that packages of parallel traded products contained drugs that were not the same as the drugs made by the professional company that had discovered them. Such products contained impurities that could cause serious side effects and in some cases death in the patient.

Julia Goldsworthy: I thank the hon. Gentleman for his point. I was just coming to that. The issue is not simply a question of different additives that might be used in different countries, but the possibility that such trade might be a soft underbelly for the counterfeit trade. There have been examples of counterfeits, such as those for Viagra, Cialis and Reductil, entering the legitimate supply chain, as the hon. Gentleman said. That is a significant cause of concern, and action to counteract it is outside the strict regulation of the industry.
	The extent to which the Government truly appreciate the scale of this problem is also an issue. Recent answers to questions asked by my hon. Friend the Member for Sutton and Cheam reveal that the Government have made no estimates of the level of counterfeit medicines circulating in the legitimate supply chain and available on the internet. If they have made no estimate of the scale of the problem, how can they deal with it properly?
	Further problems include the possible misprescribing of medication due to lack of training. Not all the problems lie at the foot of the pharmaceutical industry, but we have heard plenty of evidence this afternoon that more effective regulation of the industry will help to establish a clear balance

Adam Afriyie: I apologise to the hon. Lady for pressing her in her ill health, but can she be clear about what solutions she is suggesting?

Julia Goldsworthy: I thank the hon. Gentleman for his intervention. We support many of the recommendations outlined in the report, which seem to be sensible proposals to redress the balance between maintaining a successful pharmaceutical industry that continues to develop life-changing and potentially world-changing drugs, and maintaining and representing the best interests of the patient and the NHS. Regulation will help to ensure a more equitable balance.
	I am concerned however, that the Government have not even recognised adequately that that imbalance exists. They also seem to display a similar attitude to other, greater potential threats to public health and the available, appropriate and effective medication to deal with them. Let us hope that today's debate will help the Government to take the first steps towards recognising those problems and addressing them, so that the public can be confident that their health will remain at the heart of the issue of when and why they are prescribed drugs.

Paul Flynn: I believe that this report is among the three best that I have seen in my 20 years in Parliament. I believe that it required a response from the Government that reflected the courage and thoroughness of David Hinchliffe and the other members of the Committee. Sadly, the Government's response is lamentable. Not only did they not respond to the Committee's clear and important calls, but they ignored many of them altogether.
	I will go along with what has been said about the enormous, miraculous progress in pharmaceuticals in the past 100 years or so. Tens of thousands of people would be dead today were it not for drugs, particularly the recent advances in cancer drugs. I make no criticism of the science involved or of that part of the work of the industry whatever. We and the Committee, however, should be very critical of the dark side of the industrythe disease-mongering, the medicalisation of society, and the way that it abuses all the dark arts to encourage all of society to believe that we are ill and need a pill every day. Recently, the greatest increase has been in the incidence of depression, for which prescriptions have risen by more than 400 per cent. in a decade. In the great majority of cases people are suffering from mild depression, but we are taught to believe that if we are sadder today than we were yesterday, we are ill, and we need medication. That is useful for the pharmaceutical industry.
	The worst aspect of that was contained in report that came out of America less than a week ago, which suggested that many two to five-year-olds need Ritalin or anti-psychotic drugs. As a consequence of this view, in America one in seven children are on Ritalinsimilar to amphetamines in some waysand worse drugs. The ambition of the pharmaceutical industry is to get us all taking those drugs, which are of questionable value.
	I want to consider in particular the effect of the pharmaceutical industry's strategy on us as MPs. About an hour and a half ago in this Chamber, a Member called for the acceleration of the supply of Velcade, I think, which my constituents can get, but many other Members' constituents cannot, because it can be obtained in Wales but not here. There was warm support and almost universal approval for accelerating NICE's processes. I briefly pointed out the results of that in an intervention.
	Let me give one story as an example. Yesterday, I received an e-mail from somebody trying to persuade me to raise with the Minister the health problems of obesity, which are well known and a serious matter. I noticed that the e-mail came from a well known lobbying company. I therefore got in touch with it and I asked it who was paying its wages. It turned out to be a group of people called the obesity council. Who pays the obesity council? It is the drug industrythe people who sell slimming aids.
	A few weeks ago, I received a letter that interested me greatly, as I had a constituent suffering from pancreatic cancer. The letter was about a new wonder drug called Tarceva, of which I had never heard. I got in touch with the letter's writer, and I felt that I must investigate the matter if such a drug would help my constituents. On investigation, however, it turns out that the cost of prescribing this drug will be 16,000 a year. Its effect was to increase the life expectancy of pancreatic cancer patients by 12 days, and it had adverse side effects including death in 10 per cent. of the patients involved. Increasingly, MPs are being approached to use our office here to put forward a case for the drug industry. That is a thorough abuse of our position. From the Health Committee, however, we had a splendid clarion call against the great abuses that have occurred.
	The Medicines and Healthcare products Regulatory Agency and the Association of the British Pharmaceutical industry work jointly together, hold joint seminars and campaign together. The MHRA, the regulatory body, is funded 100 per cent. from the pharmaceutical industry. The pharmaceutical industry calls the tune. We could give numerous examples of that. Perhaps the worst was Seroxat, on which I have had two debates in the recent past, before its problems were discovered. The MHRA set up a sub-committee to look into the issue, but it had to disband after some nine months because the majority of the members had a financial interest in the company that produced the drug. The sub-committee had to be re-formed and progress was very slow.
	The Health Committee invited me to give evidence and I was able to raise the question of the influence that drug companies have on bodies in this House, such as the all-party groups which have well-intentioned, good hon. Members on them who are trying to reduce the effects of diseases. However, almost all of them are infected by the influence of the pharmaceutical companies. An example that applies to Seroxat and the treatment of mild depression was revealed in a book that I sent to all the members of the Committee before it started its work on the issue. The book is called Medicines Out of Control? by Charles Medawar. It asks what would have happened if we had gone to see Sigmund Freud when he practised as a doctor. He gave all his patients and friends, and took himself, a medicine he knew that was believed to improve people's mental health and stability. That medicine was cocaine: it was the popular drug of the time. A later popular drug was bromide, which creates its own form of psychosis, called bromism, which was a scourge of society at the time of the first world war.
	For an awful period in the 1960s and 1970s, diazepamor valiumand other similar drugs were prescribed like smarties. That caused great distress and did very little good. There was also the experimental period of the mental health industry in the 1950s, with the inducement of deep psychosis, lobotomies, leucotomies insulin coma therapy and electroconvulsive therapy. People were used as guinea pigs and suffered greatly. Many of those therapies are rightly no longer used.
	More recently, we have had the tricyclics, which were regarded as wonder drugs, but they are now seen as old-fashioned and have been replaced by selective serotonin reuptake inhibitorsSSRIsof which Seroxat is one. When the campaign against Seroxat was mounted by a few courageous people outside the drug industry, the drug companies mounted a ferocious campaign to ensure that the voices who were protesting about the dangers of Seroxat were muffled. For example, Depression Alliance, a patient group that is virtually a creature of the pharmaceutical industry and gets 80 per cent. of its funding from itas it has admitted to mecriticised those people who drew attention to the dreadful effects of Seroxat in turning depressed people into suicidal people.
	The organisations that emerge with great credit are those that take not a penny from the pharmaceutical industry, such as MIND, which continues to act in the patients' interests. Many so-called patient organisations still receive instructions from and carry out the work of the pharmaceutical industry, and some otherwise splendid organisations are affected. For example, on the day that Vioxx was banned, I went on to the Arthritis Care website. I greatly respect that organisation and it does fine work in encouraging the use of non-drug interventions such as exercise in the treatment of arthritis. On that day, its website told people not to panic if they were taking Vioxx. That drug has been identified as causing 144,000 heart attacks and strokes in the US. I would have thought that reasonable advice in such circumstances would be to panic, if people were taking such a drug. The website also advised people to visit their doctor and follow their advice about changing to another drug. However, it is significant that the website of that respectable organisation contains a notice saying that the site has been refurbished with help from Merck Sharp and Dohme, the company that makes Vioxx. Even a worthy, conscientious organisation such as Arthritis Care must be influenced in some way by the fact that if it upsets the pharmaceutical companies or fails to do their bidding, it will lose some of its staff or funding. Understandably, the Committee recommended action on those patient groups, which should declare all significant funding. It also recommended that the Government should make changes to charity law to ensure that that happens. Unfortunately, the Government have stated that self-regulation should be the first resort in improving fundraising standards, so no action has been taken, although the Home Secretary maintains reserve powers.
	This House is infested with organisations that, on the surface, are perfectly good. I had some influence in one of themI shall not name itand I see that it is now organising a relaunch with help from a lobbyist. Who is paying the lobbyist? It is one of the pharmaceutical companies. Their influence is everywhere and their tentacles stretch into the Government, the patient bodies and elsewhere.
	The key, and most dramatic, moment in the Health Committee inquiry was the unbelievable evidence about the inducements given to clinicians and others to use particular drugs. One of the questioners asked whether the free trips, the holidays and the chance to take one's wife, husband or girlfriend to the Bahamas or the Alps had any effect. The witness replied that they did not, but that articles in the British Medical Journal and The Lancet did. The point, made with great force, was that the way to influence public and medical opinion was to get articles written by authoritative figures in those journals.
	As someone with scientific training who has always defended double-blind and properly peer-reviewed trials, my greatest shock in the last couple of years was when the BMJ published an article two years ago, giving examples of reports presented in the medical journalsreports that had got past the very suspicious editorsin which the conclusions did not match the data. The data said something and the conclusions said something else. There were examples of how this was done; the pharmaceutical companies write most of the reports and hawk them round for others to sign and approve. They get some figures and they provide some fat fees.
	This element of ghost-writing, raised by my right hon. Friend the Member for Rother Valley (Mr. Barron) in opening the debate, is a matter of great concern, and it is continuing. We saw the accounts given by Dr Blumsohn in last week's edition of The Observer. I met this gentleman and heard what had happened in his case. People talk about life and death; often, it is death and death. The number of people who have lost their lives from an adverse reaction to drugs is enormous. In America, it is claimed that the fourth-largest cause of death is adverse reactions to drugs.
	The Leemon McHenry Hastings centre report pointed out that the companies first select the data that promote the drugs. They file away the results that are unfavourable and buy the right academic credentials to sign a ghost-written article produced by marketing department staff or by public relations agencies employed by the company. What are we to regard as the fundamental science, the authoritative work, to which doctors and physicians look if they want to approve a new drug? We know these articles are being ghost-written and the case of Dr. Blumsohn, published last week, made it clear that the companies refused to give him the data on an article to which his name was attached. They claimed his authority for the article and he had not seen the data.

Adam Afriyie: The hon. Gentleman is making a powerful case. NICE does a good job, but is he confident that it will pick up these erroneous reports, trials and information in its processes?

Paul Flynn: We all hope so. Like many, I thought that having a rational and genuinely independent body to look at these matters was a fine reform. The difficulty is the pressure that we all feel as human beings. If a member of our family or a close constituent wanted a drug, we would go along with it, even if there was only a 1 per cent. chance of success, and would want to hurry NICE along. But if we as politicians take a decision, as we should, we should look at what happens with rushed approvals. The reason that Seroxat caused problems was that it was approved off-label for people under 18 when it had not been trialled.
	As I said earlier, a fairly recent report, published since the Health Committee report, said that we withdrew 24 drugs in the long period between 1971 and 1992, while the United States withdrew only nine. We had approved all those 15 other drugs, which did a great deal of damage, when America had refused to approve them. A balance must be madethis is often impossiblewhen patients who suffer from terminal diseases demand drugs that might have even a very slim chance of postponing the inevitable. They want us to approve those drugs, and we politicians tend to put pressure on NICE to give quick decisions.
	The evidence is that that the faster the licensing process works, the more frequent the problems and a greater number of lethal reactions take place. If we continue to accelerate our review times, there will be more adverse reactions. That is a difficult case to put across, and it is perhaps almost impossible for us, as politicians, to do so when we see someone sitting in our surgeries telling us that they have a fatal disease and want a drug that might be available in France or Wales, but not elsewhere.
	Dr. Blumsohn spent a year requesting to see the full data on which the work that was published under his name was based. He was one of two lead authors. Two years after raising his concern, he was suspended from his university post. In The Observer last Sunday, Proctor and Gamble is reported as saying that it is standard industry practice not to hand over all data to professionals. That seems extraordinary, and it is regrettable that the Government have failed to respond in any way to that crucial issue in their response to the report. That is the key issue turned up by the Health Committee.
	No reforms are proposed for the Medicines and Healthcare products Regulatory Agency, although it has been criticised in debate after debate in the House because of its nature, organisation and funding. That was another main concern that the Government left untouched in their response. The MHRA is still 100 per cent. funded by the industry and the system relies on self-regulation. There is talk of reviews every four years, but a thorough, independent review was not agreed to.
	We have seen the pathetically weak response from the ABPI, which was mentioned by the hon. Member for Falmouth and Camborne (Julia Goldsworthy). An early-day motion was tabled last nightit has amassed one signature so farand I tried generously to amend it to point out that there was presumably some support for the ABPI in praising its new code. As the hon. Lady rightly said, the code of practice has been described as weak by the BMJ and by the Drug and Therapeutics Bulletin. She rightly made the point that the ABPI has never expelled a member. It has never even forced one of them to publish any corrective statement, although there are dozens of examples of misleading advertising and products that should not have been marketed as they were. We are dealing with a defensive group, lobbying for and defending the industry and putting at the top of its priorities not the concerns and health of the public, but the financial interests of the pharmaceutical industry.

Brian Iddon: My hon. Friend paints a very black picture indeed of the pharmaceutical industry. I cannot deny that the industry has had some failures, but would he admit that, overall, its benefits far outweigh its deficiencies? Would he admit that the large mental institutions have been emptied by the introduction of modern drugs for the treatment of mental illness? Would he admit that the treatment of cardiovascular disease has been revolutionised by the introduction of beta blockers? Would he admit that the treatment of ulcers has been revolutionisedindeed, no ulcer patient goes into hospital anymoreby the discovery by Smith Kline and French at Welwyn Garden City of H2 inhibitors, of which cimetidine was the first? Would he admit that the pharmaceutical industry does far more good than harm of the kind that he is highlighting?

Paul Flynn: I agree entirely; we could continue to record such successes at great length. Indeed, I think in my opening remarks I used the word miraculous when talking about the industry. I am trying to separate the job creation and the benefits to humankind, which have been enormous, as my hon. Friend said, from the marketing side of the industry. That is the whole point of the debate. We want to give the industry the pat on the back that it definitely needs, but we also want to draw attention to the points that the Health Committee legitimately raised.

Brian Iddon: So will my hon. Friend admit that scientists throughout the pharmaceutical industry are acting purely ethically and that the main trouble lies with the marketing of drugs, and with the salespeople and accountants of those firms?

Paul Flynn: I am not sure whether my hon. Friend was present earlier, but I tried to make that distinction when I said that the integrity of the scientists in the industry and their devotion to their work was not in question.
	The Select Committee report called for much greater action from the Government in every way. It is disappointing that so few members of the previous Committee are members of the new one, but I am sure that the new Committee will vigorously take up the report and the deficiency in the Government's response to it. As my hon. Friend the Member for Bolton, South-East (Dr. Iddon) said, enormous strides have been made in the work of the drug industry over the years, but there is still an awful energy in the industry that is used with malign effectdisease-mongering by inventing diseases and then a cure for them. The medicalisation of society has proceeded at a great rate and is looting huge amounts of money from the national health service to the detriment of other services. The drug budget increases constantly. Some of those drugs are essential and life-saving but others are not; in fact, they are life-damaging.

David Amess: The hon. Member for Newport, West (Paul Flynn) has strong views on these issues. He and I have discussed them on various occasions, and we are joint officers of a group that is particularly interested in such matters. I am not sure how widely the hon. Gentleman's views are shared in the House. He may prove to be a Churchillian figure and eventually his views will be shared by a majority of us. As a member of the Select Committee, I am grateful for his support of our views.
	The inquiry into the influence of the pharmaceutical industry was the idea of David Hinchliffe, our excellent former Chairman. I am sure that his successor, the right hon. Member for Rother Valley (Mr. Barron), will prove equally excellent. It is a shame that David Hinchliffe, who retired at a relatively early age at the last election, is not with us this afternoon. He was keen to hold the inquiry, a highlight of which was our visit to Australia. I warn the House that I shall shortly be submitting a photograph taken on that trip to the caption competition in The House Magazine. I was not in the photograph, which shows a number of my colleagues who look like Snow White and the seven dwarfs. I hope that the winner of the caption competition will invite me to enjoy a glass of whisky.
	As the hon. Member for Newport, West said, unfortunately only two members of the Select Committee responsible for the report are in the Chamber today. That is no discourtesy to the House. One of the members who participated in the inquiry, Patsy Calton, tragically died at an early age. As several other such members were regrettably defeated at the last electionI say that genuinelythe membership of the Committee changed.
	The report is excellent. Following on from a point made by the hon. Member for Newport, West, may I say to the Minister that we are just a little disappointed that in contrast to many responses to the report, the Government seem to have said no to more of our recommendations than is usual? I would appreciate hearing from the Minister why the Government were so firm.
	I now part company with the hon. Member for Newport, West because there is a danger that this is a debate in which we will want to have our cake and eat it at the same time. After hon. Members have heard my speech, they might say, Hang on, that is exactly what the hon. Member for Southend, West has just done. The United Kingdom owes a great debt of gratitude to the pharmaceutical industry for its funding of significant amounts of medical research and the consequent reductions in cost to the national health service.
	There is an argument that the regulatory burden on developing new medicines has increased markedly over the past two decades and that the balance between risk and benefit has been tipped a little too far in favour of the former. The National Institute for Health and Clinical Excellence is an important body, and my hon. Friend the Member for Windsor (Adam Afriyie) has referred to it several times today. However, our report said that the recent cut to its budget might have a significant impact on the speed at which new medicines reach patients. The Government's recent moves to extend the prescribing power of nurses and pharmacists, which many of us welcome, might render it more difficult to restrain the growing influence of the pharmaceutical industry and the increase in the medicalisation of our society.
	I hope that I will not regret making this statement, although it will please the hon. Member for Newport, West, but there is a view in certain quarters that we can sometimes be seen as a nation of hypochondriacs. We all know about those who are really ill and perhaps never even go to a GP, while other people always think that they are dying, although they invariably live to be 100 or more. All the new products on the market to make us look more wonderful and feel better pressurise people to think, It's out there; let's have it. However, as the hon. Member for Bolton, South-East (Dr. Iddon) said, that is perhaps due to accountants and advertisers, rather than scientists, who do such wonderful work.
	There was a theme throughout the Health Committee's inquiry that highlighted the increased medicalisation of our society. Every malfunction in the human body can now be diagnosed as a defect and some sort of medication is available to treat it. It is thus no surprise that self-medication is on the increase and that GPs are put under more pressure by their patients. People can now access websites on which they can find out about whatever their problems are. I was interested by what was said about pancreatic cancer because many of us deal with constituents who come along and say, My loved one is in dire straits. Here's this product; what can you do to try to make it available? It is difficult to deal with such a situation.
	The phenomenon is symptomatic of the pharmaceutical industry. It can be argued that the industry has been left to its own devices for too long. That was the thrust of the Health Committee report. The industry can target not only general practitioners, hospitals, treatment groups, medical journals and professional bodies in distribution campaigns, but individuals as well. The Health Committee thought that that practice put genuinely ill and vulnerable people at risk to some extent. Everyone, including patients and consumers, should be protected from pharmaceutical companies' persuasive product pushing. As a Conservative, I am certainly not in favour of the nanny state, but a balance must be struck and there is a role for Government, which is why we are genuinely disappointed that more of our recommendations were not accepted. The powers of the statutory regulatorthe Medicines and Healthcare products Regulatory Agencyshould be strengthened to ensure that the evidence produced by pharmaceutical companies truly reflects the findings of their clinical trials. That research should be undertaken in a professional manner, and the disadvantages as well as the benefits of licensed drugs should be well known to people who prescribe and use them.
	I welcome the revised and updated Association of the British Pharmaceutical Industry code of practice, which was announced on 16 November. It will govern the UK-based pharmaceutical industry's relations with health care professionals from January next year. It highlights the key priority of patient safety, and sets guidelines and restrictions on pharmaceutical companies' advertising strategies. It bans promotional competitions, including one cited in the Library briefing. In September 2005, a dentistry magazine featured a promotion for the drug Periostat that included a competition to win an iPod Mini. I have not entered the competition, but I am tempted to encourage my children to do so, as they all want iPods for Christmas.
	Responsibility for ethical practices should not lie with the pharmaceutical industry alone. The Health Committee strongly recommended that doctors should be obliged to declare significant sums of money or gifts that they receive as hospitality, and that they should register them with their professional bodies. The profession will say that only a tiny minority is involved but, even so, we believe that those gifts should be registered. Likewise, the ABPI code tightens the rules on hospitality, stating that delegates to company sponsored events, as we have heard, should only be flown economy class. However, it does not go as far as banning provision for five-star hotel accommodation, which is a shame.
	The ABPI says:
	There are rigorous guidelines for conducting clinical trials and a code of practice governing all promotional activities.
	Despite those assertions, a number of practices have emerged that are clearly against the public interest, including the suppression of negative clinical trial findings resulting in a body of evidence that does not allow a transparent view of a product's risk-benefit ratio. That is especially important, as guidance such as that produced by NICE is based on such published evidence.

Ian Gibson: Is the hon. Gentleman aware that a Sheffield university lecturer was sacked because, although he was not quite a whistleblower, he queried a decision? He began some work, the results of which were sent to Proctor and Gamble. He queried the company's decision to allow a drug on to the market, and he was sacked. Is that ethical and is it good practice, or is it a one-off event?

David Amess: The House will have heard what the hon. Gentleman said. It is a valuable intervention, which I know the Minister heard. I hope that the case was a one-off, but I suspect not. We should reflect on it, and perhaps the Minister will respond.
	It is gratifying that the industry is being forced to look seriously at the concerns that we raised in the report about its professional practices. It should be stressed, however, that the code is voluntary, without the backing of law. The code promises reforms to speed up the complaints procedure, with tougher measures to withdraw products during investigations, but on close examination, the sanctions for companies that break the code are lightweight in relation to the serious implications of such failings, with naming and shaming taking preference over financial penalties.
	I shall not attempt to pronounce the name of the editor of the Drug and Therapeutics Bulletin. He was quoted in the British Medical Journal on 26 November as saying:
	This has been heralded as a new dawn in the promotion of prescription medicines and allied activities. But the problem is that the code is fundamentally weak because the ultimate sanction a company faces for breaking it is very limited.
	Indeed, the ultimate sanction that a pharmaceutical company can face for breaking the code is expulsion from the Association of the British Pharmaceutical Industry. As the House has heard, that has never happened. What we should be striving towards instead, as the Select Committee report suggested, is the strengthening of the MHRA, the statutory regulator that exists purely to protect the public interest, independently of the industry.
	I am not suggesting that the Department is naive enough to assume that the interests of the health sector and of the pharmaceuticals industry are synonymous. Clearly, although there is an overlap, the former is driven primarily by patient care and the public interest, whereas the latter must also weigh medical need against the returns that it will get from its investment. This is why, quite wisely, the Committee concluded that a key recommendation of its report would be that the sponsorship of the industry be passed from the Department of Health to the Department of Trade and Industry, so as to avoid that conflict of interest. I very much regret that this recommendation was rejected by the Government in their response to our report. I hope the Minister will comment on that.
	Overall, the tone of the Government's response was complacent. We have heard from the Chairman of the Select Committee that he was responsible for geeing up the response. Whether it was prepared too quickly I do not know. In reply to a number of the Committee's concluding recommendations, the Department of Health stated that the current guidelines or measures were sufficient to deal with the concerns raised. The Committee does not accept that. For example, the Government did not strongly support the Committee's proposals to subject the MHRA to an independent review that would examine the regulation process with a view to making it more transparent. I much regret that.
	The need for more transparency in the industry was another ongoing theme throughout our inquiry, not only so that medical practitioners and the public can make informed judgments about the evidence they are presented with by the pharmaceutical companies, but so that they are more informed about the materials considered by the MHRA in its inquiries. It was disappointing that in their response, the Government committed only to a suitably planned review of the MHRA
	perhaps on a four-yearly cycle,
	without giving a start date for the review cycle, which leaves us unclear as to whether the process will go ahead. A four-year cycle is too loose and not realistic enough.
	The issue of independent regulation is given added salience when we consider a series of controversial treatments that have hit our headlines in recent months. The hon. Member for Newport, West mentioned that following the death of a patient who had been taking the painkiller Vioxx, which, as he rightly said, has been shown to increase the risk of heart attacks and strokes, a US court found against the responsible company, Merck. During the case, it emerged that Merck had deliberately hidden its reservations about the treatment, which was a worrying discovery.
	Here in Britain, the Minister announced at the end of October that primary care trusts should fund the treatment of Herceptin for the early stages of breast cancer, if it is clinically appropriate. He has probably not had time to read his boss's comments to the Health Committee on Tuesday, when the Secretary of State for Health was involved in an interesting exchange with a Labour Member. Herceptin has not yet been licensed for treatment in early cases, and to allow a politician to bypass all the licensing safeguards to demand that a treatment should be made available on the NHS is surely not a precedent that we should set.
	Two weeks ago, I asked the chief medical officer about inoculation against tuberculosis. The old product ceased to be used when Parliament broke up for the summer recess, so there was no chance to challenge the decision in Parliament, and the new product is unlicensed. I do not want to start scaremongering among the general public, but I am concerned about the message that is being sent out. The House has probably forgotten that change, although I do not bear the scar of a TB inoculation.

Andrew Lansley: Does my hon. Friend agree that although this matter is not covered in the Health Committee report, the mechanism for the approval of vaccinations and immunisations is still within the hands of the Department of Health and does not rest with National Institute for Health and Clinical Excellence? On TB testing, there is a very good case for examining the efficacy of the old technology for skin tests compared with new blood-testing technologies, and I have asked questions about that matter. At the moment, the mechanism sits inside the DOH and vaccinations and immunisations are not exposed to an evidence-based appraisal by NICE.

David Amess: I like where my hon. Friend is leading me and am aware of his interest in the matter. The Minister has heard our exchange, and I am sure that the general public will become increasingly interested in what is going on. We certainly need to clarify the matter.
	It is vital that new drugs are proven to be of real therapeutic benefit to patients, and clinical trials should therefore aim to produce health outcomes that are relevant to patient care rather than relevant to the profits made by pharmaceutical companies. That is whythe Health Committee made the sensible recommendation that better communications should be established between the Medicines and Healthcare products Regulatory Agency and the pharmaceutical companies in the early development stages of a drug. There should be more post-licensing monitoring of medicines, which requires systematic appraisals of drugs on the market. I hope that the Minister will comment on that point in order to reassure the Committee.
	There is no doubt that medicines contribute enormously to the health of the nation. The hon. Member for Newport, West is not present, but I was concerned by his remarks about drugs to assist people who are depressed or who have other mental health problems, because I think that he overstated the case against those drugs. For many people, they are the source of a better quality of life, negating the need for surgery or other invasive treatments.
	Economically speaking, the production of pharmaceuticals is the third most profitable activity in the United Kingdom after tourism and finance. The UK should be very proud of the many achievements of its domestic pharmaceutical industry, as it has an excellent global reputation for scientific research, accounting for 10 per cent. of global research and development expenditure.
	In order to maintain that wonderful reputation, the Government must act to protect the public, especially the elderly and less well-off, who are the biggest users of prescription-only treatments but also the most vulnerable people in society. It would be unrealistic to rely on the pharmaceutical industry to protect the public interest through self-regulation, but neither must we over-regulate through the statutory body. All restrictions on pharmaceutical companies must be targeted, and they must have a clear purpose in the promotion of public safety.
	I believe that the United Kingdom's pharmaceutical industry is a respected and highly lucrative business, but I also believe that it is the Government's responsibility to ensure that it remains so.

Brian Iddon: I have not come prepared to give a speech, but I should like to comment briefly on patient safety. I congratulate the Health Committee on an excellent report and my right hon. Friend the Member for Rother Valley (Mr. Barron) on introducing the debate.
	I turn first to internet sales and self-medication, although the report does not cover that particular aspect. We are reaching the point where we have to think about regulating internet sales of medicines. A growing number of people are buying medicines that are available in this country and cheaper on the internet or that are unavailable in this country and have potential risks attached to their use. I am worried that people may be putting themselves at risk by self-medicating in this way. I am told that some of the information associated with these products that is given on the internet can be inaccurate. People should therefore use it with caution. I ask my hon. Friend the Minister to consider that.
	Parallel trading is of even greater concern to me. Britain is one of the leading research countries in the discovery of new medicines. We have a very proud record, going back to the early sulphonamides and leading up to some of the most advanced anti-cancer drugs of today. That fine record continues to thrive, for various reasons. We have a good science base. The universities produce excellent scientists and medical people who do the research. We have tremendous hospitals that carry out excellent clinical trials, despite what has been said.
	The whole environment in Britain is conducive to the discovery of first-class medicines. The pharmaceutical industry is of course profitable, as we have just heard. The pricing structure for the purchase of drugs by the national health service aids in the discovery of drugs in this country because medicines are sold at a higher price to the NHS than they are in many other countries throughout the world, including in Europe. Products that are available in this country can also be bought in Greece, but a country such as Greece does not contribute to the research and development of drugs to anywhere near the degree that Britain does. A product will be on sale in Greece, and in many other countries, at a much cheaper price than in Britain. The pharmaceutical companies in, for example, America, Germany and Britain export their products to countries such as Greece and Bulgaria with foreign-language packets and foreign-language inserted leaflets, so that the patient knows about all the side effects. An entrepreneur can therefore pick up those products in Greece much more cheaply than he or she can buy them in this country. The entrepreneurs then trade them back to Britain, where many may have been made in the first place.
	There is a requirement to repackage the product if the box and the leaflet inside it have been printed in a foreign language. Therein lies the difficulty. The boxes are reopened, the leaflets are removed, new leaflets are put in, sometimes new labels are stuck over the French or Greek on the box and, often, even the boxes are reprinted. The product is then sold through the outlets that are commonly available in this country. That might appear okay, but there are problems.
	Earlier this year, the Science and Technology Committee visited the small African country of Malawi. We split up into two teamsan agriculture team and a health teamand I joined the health team. We visited hospitals in Lilongwe and elsewhere in the country. I visited a small district hospital in the centre of Malawi, which orders its drugs for some very sick patients from the central stores in Lilongwe. They are supposed to reach the hospital on the back of a wagon. Unfortunately, corruption is rife in many African countries as in many countries throughout the world. Many drugs do not reach the patients; they fall off the back of a wagon into the hands of a criminal entrepreneur. Consequently, patients die of tuberculosis, AIDS, HIV and all sorts of tropical diseases. They die as a result of parallel trading.
	The entrepreneur trades the product that has been exported from a western country to Africa back to the western country because it is available much more cheaply in the African country than it is in, for example, Britain. Those parallel traders cause immense damage. In repackaging the products and sticking in another leaflet, mistakes can be made. For example, the drugs can be mixed up. However, I am even more worried about parallel trading from what I heard recently. As I said earlier, my great worry is counterfeiting.
	The trade in counterfeiting drugs is growing at an enormous pace. People are copying drugs all over the world. Last evening, at a joint meeting of the all-party group on the packaging manufacturing industry and the all-party group on pharmacy, I heard that the counterfeiters are professional and are even buying the same packaging material as the professional companies usefor example, Pfizer in Kent. Obviously they do not have the same careful production processes and, in particular, they do not have the same quality control processes.
	Last night, we were shown pictures of drugs that had been counterfeited. They had been made chemically, using the same processes, but there are impurities in all chemical processes. Our pharmaceutical companies have good quality control to ensure that there are no dangerous impurities in the drugs on the market in our countries.
	So, what happens? A drug is counterfeited, often with impurities in it, and placed in packaging identical to that produced by firms such as Pfizer, GlaxoSmithKline and AstraZeneca. We were shown examples of those packages last night. When they were placed side by side with the real ones, we could hardly tell the difference. Inside the packages, the leaflets and blister packs also looked authentic. When we in the audience were asked which was the authentic drug and which was the counterfeit, or parallel-traded, drug, it was very difficult to tell the difference.

Charles Walker: Is the hon. Gentleman aware that organised criminals are moving into this field because it is more lucrative than narcotics?

Brian Iddon: I agree. I am suggesting that criminal entrepreneurs have now entered the parallel trading market. Last night, I was given a figure for the amount of counterfeit, parallel-traded products that are now entering the market in this country. I shall not repeat it because I cannot remember it accurately, but it was a very significant figure indeed. I ask my hon. Friend the Minister to listen to the industry on this issue, because it is now complaining very loudly, not only directly to the Department of Health but through trade organisations such as the Association of the British Pharmaceutical Industry.

Ian Gibson: Is my hon. Friend saying that pharmacists do not know where the pills have come from? Do they simply make a judgment based on the colour of the box? How do they know whether they are getting the real thing?

Brian Iddon: Pharmacists often do not know where the box has come from. Last night, we were shown a trick that the pharmaceutical companies have introduced. They have invented a new kind of print that is stuck on to the box. In the example that we were shown, the name Pfizer was used. The pharmacist is provided with a device that allows them to match an example of the print with the print on the box. If the print on the box is not authentic, it is possible to see the difference. However, it will not be long before the criminal entrepreneurs are doing the same thing.
	Last night, we discussed how we could prevent the counterfeiting of drugs and the use of the parallel trading system. One suggestion was that electronic tags could be placed in the boxes. I suggested to the meetingand I suggest to the House todaythat when a pharmaceutical product leaves the factory, it goes out with a transport audit. For example, if it had been manufactured by Pfizer, it would come out of Kent and the transport audit would follow it through every stage of its journey. Perhaps, however, I have not thought the idea through; criminal entrepreneurs could find a way round that, too.
	I must tell the Minister that we urgentlyand I do mean urgentlyneed to have discussions about this matter, otherwise patients in our national health service are going to start dying as a result of taking these contaminated, counterfeit, parallel-traded products.

Richard Taylor: I should like to start by echoing the comments of the hon. Member for Southend, West (Mr. Amess), who paid tribute to the previous Chair of the Health Committee, the former hon. Member for Wakefield. I also pay tribute to the staff of the Committee, particularly the excellent Committee specialists, who assist the Clerks so ably. I also echo the comment that the right hon. Member for Rother Valley (Mr. Barron) has shaped up well in his first few Health Committee meetings.
	I agree with the hon. Member for Newport, West (Paul Flynn) that the Government's response to the report was rather slim. It was also incredibly late. We finished our report on 5 April, but the response did not come out until September. I had imagined that the people who wrote these responses would not have much to do during the general election campaign. I do not think that the Minister wrote very much of it. Why was the response released right in the middle of the recess, when no one could really comment on it and we could not get any press coverage?
	My other complaint about the response is that it is the most difficult one to follow that I have ever seen. We made 48 recommendations. The Government, in their wisdom, have renumbered them, so anyone who reads them has to have both copies open in front of them. They would need to work out that our recommendation No. 18 was the Government's recommendation No. 2. Perhaps we made a mistake with the heading Conclusions and recommendations. The Government may have thought that they were to respond to recommendations and not to conclusions. In any event, they responded to only 32 of our 48 recommendations, although, to be fair, some of their responses to those covered some of the others.
	Although much has been said by other Members, regrettably only the hon. Member for Southend, West and I were on the Committee. I think that I can reassure those who were photographed in a remarkable disguise. The hon. Member for Southend, West somehow avoided that. I must take it up with him afterwards: why on earth was he not present? The disguise was like Ku Klux Klan garb, without the pointed hat but with just a narrow slit to look through. As I do not think that many of us will have been recognisable, I am not too worried.
	Members have left me a good deal to cover. I shall begin with research. Five recommendations mentioned it, but only one was given the honour of a reply. As is well known, the Department of Health invests about a sixth of the amount invested by the drugs industry in researchabout 0.8 per cent. of its budget. That may be why it did not feel willing or able to comment on an activity that is funded so generously by the industry.
	Our recommendation 2I had to struggle to remember what number we gave itwas not mentioned in the response. It states:
	Priorities for research into medicines inevitably reflect the interests of the pharmaceutical companies and are not necessarily well aligned with the medical needs of all patients. The industry will continue to undertake the bulk of research in this area, but there are improvements which could be made. We welcome Lord Warner's recognition of this and look forward to his proposals to align more closely the drug companies' research strategies with the public health aims of the NHS.
	I thought that if Lord Warner, a Minister of State at the Department, had said that, there should have been a response, but try as I might, I could not find it.

Ian Gibson: Did the Committee's study of research reach any conclusion on the merger mania in the pharmaceutical industry? When Glaxo and SmithKline merged, Sir Richard Sykes and Jan Leschly said that research would benefit from the merger because they would be working together. Is there any evidence that mergers lead to better research?

Richard Taylor: I do not think that there was any hard evidence that that merger had produced an increase in research, but I do not think that we asked the question, so regrettably I cannot help the hon. Gentleman. The one thing I remember only too well about the Glaxo merger with SmithKline is that I had to sell my shares so that I would not have to declare an interest.
	Several Members mentioned me-too drugs, the duplicates or near-duplicates of existing drugs, which are relatively cheap for companies to produce. We were rather down on them because of the number available. Three or four beta blockers will provide all that is needed in terms of variety, as will a small number of non-steroidal anti-inflammatory drugs. We issued a plea for a wider distribution of really effective local drug and therapeutics committees working over acute and primary care trusts to introduce some control to prescribing of that kind.
	Clinical trials have already been mentioned briefly and several recommendations in the report refer to them. We wanted an independent register and records kept of negative trials and of drugs that were terminated due to side effects. We wanted to ensure that comparator drugs were used and that the particular comparator drug was the right one to choose. We wanted drug treatments to be compared, where possible, with non-drug treatments. It is not clear from the Government's response whether they have taken all those details into account; they seem rather to hide behind European rules.
	I feel very strongly about the promotion of new drugs. Our recommendation 5, which was not answered, stated:
	The aggressive promotion of medicines shortly after launch, the sheer volume of information that is received in its many forms by prescribers and the 'promotional hospitality masquerading as education', in the absence of effective countervailing forces, all contribute to the inappropriate prescription of medicines.
	I thought that that was a powerful recommendation.
	I am interested to hear other hon. Members' comments on the Association of the British Pharmaceutical Industry code of conduct. I am slightly less dismissive of it than others. I agree that there may be an element of window dressing, as mentioned by the hon. Member for Newport, West, but I hope that it is at least a first attempt at self-regulation. In other inquiries, such as the one into obesity, the Health Committee has recognised that self-regulation of the food industry was probably a more practicable measure to aim for than strict regulation from outside. I will study the code of practice carefully. I am not sure whether it covers either ghost-writing or fees to experts, which are important matters.
	Returning to the intensive promotion of new drugs, I would like to refer to another recommendation. To avoid confusion, it was our recommendation 33, though it appears as recommendation 6 in the Government response. Our recommendation stated:
	The intensive marketing which encourages inappropriate prescribing of drugs must be curbed. Present methods of supplying independent information, as described by Lord Warner, are inadequate.
	We went on to recommend that
	the promotional material for a new product
	should be pre-vetted by the MHRA. I believe that that is going to happen. We further recommended that
	consideration be given to limiting those who can prescribe a new drug in the two years following launch. Drug and Therapeutics Committees would be well-placed to implement this.
	That provides another function for such committees.
	In their response, the Government agreed that there should be proper controls, but they subsequently lost the plot completely, saying:
	There is no indication that the measures currently in place are not effective. The fact that generic prescribing has risen to nearly 78 per cent. (in 2003) clearly indicates that clinicians are writing prescriptions generically and not by individual company product.
	One cannot write a prescription generically for a drug that is new and under patent because it effectively does not yet exist. I was not very impressed with that aspect of the Government response.
	An example of the rapid uptake of a new drug causing problems is of course Vioxx. It has been referred to by several Members today, but I will go over some of this ground again because it is so important. Vioxx was launched as an answer to all the upper gastrointestinal problems that undoubtedly occur through the use of existing anti-inflammatory drugs for various forms of arthritis. It was introduced in 1999 and withdrawn in September 2004 when work in America showed how dangerous it was from the point of view of causing heart attacks and strokes.
	To express a slightly different view, we lost what was thought to be a potentially useful drug due to the unpredictable side effects brought to light by very widespread, very rapid prescribing. I have spoken to drugs firms about this and they claim that in fact, it was a good thing that Vioxx was prescribed so widely, because doing so brought the side effects to light much more quickly. I do not quite follow that argument.
	During the inquiry, we visited University College London hospital to hear about its Use of Medicines Committee. We were incredibly impressed with its drug formulary, which is used not only by the hospital trust but by the nearby primary care trusts. Because members of those trusts are on the committee, it is also well accepted by the GPs in the area. Its prescribing levels of Vioxxsurprise, surprisewere lower than the nationwide average because it had careful guidelines. It took the view that this is a new drug and no one knows entirely what is going to happen, so we should be careful with it, please.

Paul Flynn: Does the hon. Gentleman believe that, given the problems with Vioxx, which is just one of the COX-2 inhibitors, there is reason to look carefully at other such inhibitors? Some 1 million prescriptions were issued for Vioxx, but 3 million prescriptions have been issued for other COX-2 inhibitors that are still being prescribed.

Richard Taylor: I agree absolutely with the hon. Gentleman, and I shall deal with another point relating to COX-2 inhibitors in a moment.
	On the explosion of new drugs, several of our report's recommendations pointed out that prescribers must share part of the blame; we cannot put it all on to the pharmaceutical companies. In this respect, local drug formularies are vital. Prescribing should possibly be limited to certain groups of doctors, and they certainly should have better education on these matters. Both the British National Formulary and the Drug and Therapeutics Bulletin are absolutely essential in that education process.
	I am rather worried by a communication that I received just yesterday from the Drug and Therapeutics Bulletin, in which it pointed out that it is in discussions concerning its contract with the Department of Health to supply the bulletin free to 117,000 health professionals. At the moment, the Department of Health takes out a bulk subscription for doctors, nurses and other people who prescribe drugs. This little publication consists of just four pages. It can be folded, fitted into the pocket and read in the lift or on the tube, but it is incredibly important and valuable. A survey has shown that 89 per cent. of its readers find it either very or quite influential. It is in the top three of the most-read of such publications. The vast majority of respondents86 per cent.cited its independence as a very important factor. So I ask the Minister to examine the question of the withdrawal of that bulk subscription very carefully. The bulletin is extremely valuable to the 117,000 people who receive it.
	I emphasise that the restricted prescription of new drugs is automatic when advances are made with drugs. Examples of that would include the new treatments for cancer or rheumatoid arthritis, for instance, as such drugs would be prescribed only by consultants. The recommendation mainly applies to the more popular drugs, such as those in the Vioxx group and, as usual, a balance must be struck between the pharmaceutical industry's need to get a return on its huge investment and the requirement to ensure patient safety.
	I do not know whether the hon. Member for Newport, West saw last week's British Medical Journal, but it contains a most interesting report on a large group of patients who took one of the Vioxx group of drugs. The results throw into doubt suggestions that the drugs in that group are safer than the ordinary non-steroidals used for the gastrointestinal tract. The article is very interesting, and shows that we cannot win in this respect.
	I was trained by wise and experienced physicians in the good old Westminster hospital, only about half a mile from here. One of them was practising when cortisone was invented and he had seen patients who were crippled with rheumatoid arthritis be cured absolutely for six weeksthe so-called cortisone honeymoonbut who had to come off the drug as soon as the side effects became evident. I was brought up to be extraordinarily careful with new drugs, because doctors do not, and cannot, know what they do. For example, thalidomide was introduced just after I qualified, and I am ashamed to say that I probably prescribed that drug for some people when I was a houseman at Westminster hospital.
	The first duty of a doctor is not to cause harm. With reference to that, I came across the marvellous proverb:
	A merry heart doeth good like a medicine.
	Sadly, that needs to be brought up to date so that it says like a good medicine, as I am sorry to say that some medicines are not good, contrary to initial appearances.
	I also came across a quotation from Sir William Osler, as follows:
	The desire to take medicine is perhaps the greatest feature which distinguishes man from animals.
	The drug industry therefore has an extraordinarily favourable market right from the beginning: people want to take medicines as they do not believe that other types of treatment work. That brings me to the need for regulation, a matter that has been covered extensively by several hon. Members already.
	I am sorry that the Government have not agreed to an independent review. I am hoping against hope that the four-yearly cycle review will be independent, that it will cover the ground set out by the right hon. Member for Rother Valley and so go some way towards removing concerns about the independence of the MHRA.
	Just yesterday, concern was expressed to me that the replacement organisation for the Committee on Safety of Medicines, which was abolished on 31 October, is not yet in place. The Minister will correct me if I am wrong, but I understand that the expert advisory groups that will take the place of the CSM in advising the MHRA have not been set up yet. During that gap, are patients more at risk? I believe that the groups will not be in place until February, and they will not be functional immediately, so for how long will there be a gap during which patients are probably vulnerable?
	On post-marketing surveillance, which has also been covered quite well, let me quote recommendation 29, which was our paragraph 45:
	We recommend that the extent, cost and implications of illness resulting from the use of medicines be systematically investigated by the Department of Health in conjunction with the MHRA.
	It is known, as the Government's response states, that the burden of adverse drug reactions on the NHS is high, with 6.5 per cent. of hospital admissions due to it.
	Why is that still happening? Many statements in the British National Formulary, which many doctors carry, will enable the sort of side effects that lead to illness to be avoided. A classic side effect of SSRIsselective serotonin reuptake inhibitorsparticularly in the very old, is to cause a drop in the sodium level in the blood, which can be extraordinarily dangerous for the elderly. Three people in my area have suffered that side effect, which is mentioned in the British National Formulary. These are matters of education to be considered.
	I look forward tremendously to electronic prescribing, which has also been mentioned, as the electronic system, when it is really working, will be able to flag up immediately side effects with other drugs or a contraindication with the age of the patient, and could make a tremendous difference.
	When the Committee visited Australia, we were impressed by the production of a series of lovely little pocket books of well-organised therapeutic guidelines across many subjects in the whole of medicine. We are lagging behind on that. The only disappointment was that it did not appear that the Australian authorities had done a trial on hospital admissions due to drug-induced illness, to see whether those guidelines, which were being used widely, were making a difference.
	Possibly one of the most controversial recommendations, which has been mentioned, related to the Department of Health's concern to represent the interests of patients, the NHS and the drug industry, which was described by some of our witnesses as cross-dressing. One of the recommendations, which was responded to but in a negative way, referred to the Department of Health's role, which, because of those wide responsibilities, perhaps does not serve the public as well as it should.
	I agree with everybody that we must retain a viable pharmaceutical industry. If we consider rough figures, however, 90 per cent. of the world's research is targeted at illnesses affecting only 10 per cent. of the world's population. We would love to see some guidance given to the major pharmaceutical industries to give some help to those huge numbers of the world's population who are not being thought of. In Australia, we came across one small firm making a microbicidal gel for the prevention of HIV/AIDS. That would be relatively cheap and a huge advance. I would love the Minister to comment on whether the Government can try to influence the industry in that way.

Andrew Lansley: Let us give credit where it is due. The World Health Organisation has instituted the global campaign for microbicides and the British Government have allocated 16 million in support between 2003 and 2006.

Richard Taylor: I am aware of that and I agree.
	The Government somehow have to balance the needs of patient safety and the industry's ability not only to survive, but to survive in a reasonably profitable form. The lesson that we learned in Australia from New Zealand was that the controls were so firm that the pharmaceutical industry had virtually moved out of that country.

Charles Walker: I am grateful for the opportunity to speak in this important debate. I thought that I would need to have my boxing gloves on, metaphorically speaking, to take on the hon. Member for Newport, West (Paul Flynn), but as I listened to his excellent speech, I found that I agreed with much of it.
	I must first declare an interest in that Merck Sharp and Dohme is based in my constituency. I am pleased to have that company there, it is a good employer and I hope that it continues to operate out of the UK as well as other countries. The pharmaceutical industry plays an important role in the UK. It employs many hundreds of my constituents and across the country it employs many tens of thousands of people. It spends a vast amount of money on researchit should be remembered that only one or two in 100 drugs on the drawing board reach fruition. Of course, pharmaceutical companies need to make returns on those one or two to fund future research. I have no objection, therefore, to pharmaceutical companies marketing more aggressively than perhaps the hon. Gentleman would like to see them do, or to their making a profit.
	Before I became a Member of Parliament, I worked in health care as a PR person. That is why I listened with great interest to the hon. Gentleman. At the tender age of 27, I was responsible for promoting certain diseases, one of which was osteoporosis, and 11 years ago, it probably needed promoting. The system works as follows. Some motivated and passionate charities are connected with certain diseases, and they have very little or no money. In such cases, generous pharmaceutical companies with a treatment for one of those diseases come along and sponsor some of the charities' activities. As I said, we needed to promote osteoporosis because so many people, especially women, were afflicted with it, and politicianswe had a Conservative Government thendid not take it seriously or see it as a priority.
	I have to say that I now regret my involvement in promoting some diseases, especially depression. While some people do suffer from serious depression and SSRIs are useful drugs for treating it, I am concerned that too many doctors, for whatever reason, prescribe SSRIs without taking the time to understand the causes of their patients' problems. I understand, from talking to many of the same charities to which the hon. Gentleman has talked, that sometimes a patient gets less than five minutes and to get them out of the door they are prescribed SSRIs, which can have serious side effects for some people and cause great discomfort. They can also be very difficult to come off. I hope that as a result of this debate the Minister will take away the concerns about SSRIs. Perhaps we need a process of education for GPs to ensure that they take more time to understand the root causes of people's problems before prescribing a pharmaceutical solution.
	I am glad that the ABPI recognises some of the concerns about support for patient groups and paid-for doctors writing in support of drug companies' solutions to an illness. Coming from a PR background, I am aware that there was always a difference between an advertorial and an editorial, and perhaps we have seen editorials that should have been branded as advertorials. There should be greater transparency. Pharmaceutical companies should make it clear which groups they support, be they academic or charities, and when a doctor or professional writing in support of a treatment is in receipt of funding from the company producing that treatment, that should be made clear.
	This was intended to be a short speech, so I shall conclude by agreeing with the hon. Member for Bolton, South-East (Dr. Iddon) on the danger of counterfeit medicine and internet pharmacy, 99.99 per cent. of which is unregulated and operated from places such as Tonga in the Pacific. Drugs that are sold back to the UK may be as harmless as sugar but, for example, if a woman were to take Propetia, it could have severe, possibly even life-threatening, implications for her health. I hope that I can join the hon. Gentleman, perhaps in a future debate in Westminster Hall, to explore that problem, which was not covered by the report.
	Madam Deputy Speaker, I thank you for allowing me to take part and I thank all Members for listening to me so closely.

Adam Afriyie: It is a pleasure to participate in this debate. We should be thankful to the pharmaceutical industry, which, over the past couple of hundred years, has introduced cures and treatments for ailments that affect many people. We should be thankful to the Select Committee for its excellent report and recommendations. We should also be thankful to Parliament for establishing the National Institute for Health and Clinical Excellence, which does good work in regulating what comes on to the market as an acceptable treatment.
	The Select Committee report and the Government response are concerned with life-and-death issues, particularly with regard to the speed with which treatments reach the market. I should like to raise three brief concerns, the first of which is the funding available to NICE. There was a clear recommendation that its funding should be increased. The Government response was fairly clear: they would look at the matter in the round in the future. It is slightly more urgent than that. If we expect NICE to do its work, the fact that so many drugs are coming on to the market and so many clinical trials are taking place mean that its funding needs to be increased, and soon. The 3.5 million that was withdrawn resulted almost directly in one of the appraisal panels being closed. Perhaps the Minister can say a few words about that in his response.
	My second concern relates to the recommendation from the Secretary of State that Herceptin be fast-tracked and that PCTs should begin allowing women with early stage breast cancer to use the treatment. I welcome that decisionby all accounts, the drug is effectivebut it raises concerns and questions. On what basis should a Secretary of State for Health intervene in the process? On what basis should the Secretary of State select a drug or treatment for fast-tracking? Surely there should be overt, rational and robust guidelines that are open for everyone to see, so that any decision is not made as a result of public pressure or, dare I suggest, PR pressure from the pharmaceutical industry. Although the decision raises some questions, I was delighted with the recommendation.
	My third concern is that medicines reach the market on the basis of robust evidence. I said earlier that if NICE is unable to see all of the evidence, clinical trials and data on a treatment, it is not necessarily in a position to make a sound judgment. If it sees only the published reports of clinical trials, it is not seeing the full picture and it cannot necessarily make a fully informed judgment.
	The House and the Government have a duty to protect people from unsafe medicines, and NICE does a good job in the circumstances. However, I urge the Minister to take a good look at, first, the guidelines for NICE to ensure that it can consider all the evidence involved; secondly, the basis on which the Secretary of State for Health can circumvent or intervene in the process of drug prescription; and thirdly, the funding available to NICE, so that, as patients and the pharmaceutical industry make more demands in the future and the evidence becomes clear that certain medicines look useful, those medicines can be processed, examined and reviewed very quickly by an excellent institute.

Andrew Lansley: This has been a very good debate, and I am delighted to have had the opportunity both to listen and to respond to it. I apologise, Madam Deputy Speaker: I am part of a Standing Committee upstairs, so I had to depart once and was unable to hear all that my hon. Friend the Member for Southend, West (Mr. Amess) had to say.
	I join other hon. Members in congratulating the Health Committee on its work. Its report has already proved to be a very important; it has led to action by the Government and the pharmaceutical industry. I am sure that the Health Committee will help to guide and press for action in the future. As the Chairman of the Select Committee said, it will return to the issue and rightly so, and it would be very useful if it did precisely that in one or two instances that I might mention during my remarks.
	I want to say a special word of thanks to David Hinchliffe, the former Member for Wakefield, who was Chairman of the Health Committee when I was a member of it in the early part of the 1997 to 2001 Parliament. He did a remarkable job. Many people across the NHS very much valued his work, and the right hon. Member for Rother Valley (Mr. Barron) will be a distinguished and equally competent successor.
	The right hon. Gentleman was quite right to point to the importance of safety, which is a central issue. I was surprised, particularly during the discussion of Vioxx, that there was little mention of the subsequent actions by the pharmaceutical industry to promote the publication of all clinical trial data. That is an important matter. The Select Committee considered the origin of the problems with Vioxx, and they were substantially related to the failure of transparency on clinical trial data, as well as, arguably, the company responses. If we are to deal with those problems, we require not only ethical responses on the part of pharmaceutical companies, but the sort of transparency that allows early indications of effectiveness to be challenged by others using the data.
	The hon. Member for Newport, West (Paul Flynn) rightly illustrated the fact that it is terribly important to use the data properly. However, if he is right and there have been instances where conclusions reported in medical journals are not consistent with the datathat would be entirely wrongit is absolutely essential that other researchers have access to the data in a form that allows them to engage in the scientific method and to challenge the conclusion that others have reached. That is what science is about. We applaud scientists for what they are doing, so we should give them the maximum opportunity to use their method in that way.

Paul Flynn: Is the hon. Gentleman aware that Eliot Spitzer in New York took GlaxoSmithKlein to court and the company was fined? That revealed a truly shocking picture of falsified research: negative results were ignored; results showing that new drugs were not as effective as placebos had been buried and not published; and the results of trials during which people had died had been suppressed. That is a dreadful record and although I tried to congratulate the drug companies on having changed their act, the past is one of deception, errors and manipulation on a scale that most of us could not imagine.

Andrew Lansley: I understand the point that the hon. Gentleman has been making and I do not doubt his long history of work on the subject. He does an important job and I do not dispute that. We need people in this place who come at the arguments from many different angles, but his argument seems to be that the bottle is one tenth empty. We must remember that the bottle is nine tenths full; the pharmaceutical industry has made and continues to make a remarkable contribution to the public benefit by improving our health.
	One of the Government's central messages is about the reduction in mortality from coronary heart disease, but they know perfectly well that that has occurred throughout the world as a consequence of the introduction of statins. That is but one example. The hon. Member for Bolton, South-East (Dr. Iddon) rightly gave the hon. Member for Newport, West a short lecture on the range of benefits that the drug industry has brought us.
	The hon. Member for Bolton, South-East was also right to point out the risks associated with both parallel trade and internet trading, which are not necessarily the same thing. Parallel trade is not illegal. It is a consequence of the fact that we do not have a single market in pharmaceuticals, nor are we likely to. I am certainly not saying that we should leap to that situation. We have to acknowledge that large price disparities, especially in parts of Europe, can have a substantial impact on trade and can dramatically undermine the intentions behind the pharmaceutical price regulation scheme. We need to be aware of that and, if necessary, adapt the PPRS in response. I shall return to the PPRS later.
	Counterfeit trade is illegal and extremely harmful. Everything I hear confirms that the scale of internet trade in counterfeit drugs is rising. Whenever there are questions about the preparations for pandemic flu and the availability of Tamiflu, the counterfeiters try to trade on that public concern and satisfy the demand.
	We have not talked much about the necessity for public information. There is a range of possibilities for better informing the public about the availability of drugs and about why some medicines should be prescription-only. We need to think hard about the circumstances in which they should become pharmacy medicines. That has been advantageous in the case of statins and the same may be true of antiviral drugs in the future.
	We must also consider the public understanding of risk, about which we could talk for a long time. If the public become direct participants in reporting adverse drug reactions and adverse events, as they will under the yellow card scheme, they need to be much more aware of risk and the kind of adverse event that we anticipate. I am sorry that there was not more discussion during the debate of the Government's response to the yellow card scheme, which is important, although we should not get too carried away. The yellow card scheme in the UK did not disclose the problems with Vioxx, nor did the Medwatch scheme in the United States. As the Select Committee pointed out, they were largely disclosed during large-scale, long-term trials, designed to establish the efficacy of non-steroidal anti-inflammatory drugs in the treatment of other conditions. That illustrates that the longer one continues the process, the more trials one does and the more patients who are exposed to a drug, the more likely one is to establish safety data. I am not a scientist, so I cannot explain how the procedure works, but I am confidently assured that although trials that establish efficacy, safety and quality for licensing purposes are immensely expensive, there are many reasons why their scale is not necessarily sufficient to establish safety against a range of untoward events. Such trials disclose immediate safety events in controlled populations, but they do not reveal less common events that could occur in larger populations. That explains why we must think about post-licensing surveillance, which is important, as the Committee and the right hon. Member for Rother Valley rightly pointed out.
	There are several factors that could help us to achieve that. The national health service could be an important international organisation in the process. It would help the pharmaceutical industry in this country if we could use effectively the connecting for health programme, the electronic patient records and everything that goes with them to create population-wide databases that would give us good information about adverse events. We have the general practice research database, but if that were to expand and migrate into the connecting for health programme, it would help us enormously. Although we have prescription-event monitoring at the moment, I understand that about 30 per cent. of GPs do not participate in it. We need something that will be effective across the board and not likely to be affected by any distortions and biases that might occur due to the self-selection of participants.
	The document Safer Medicines, which was published by the Academy of Medical Sciences only two weeks ago, makes interesting reading. I do it an injustice by picking out only one or two aspects of it, but it addresses useful matters that have not been mentioned. The document refers to conditional approval, which would occur if licensing meant not simply saying that a firm could market a drug without any further conditions, but saying that there were as yet unproven safety considerations that would have to be addressed through the subsequent use of the drug. If a company were able to extend the life of patent protection while it continued to acquire data, it would be in its commercial and economic interests to undertake much of the larger-scale work that would be necessary to acquire data from a wider population who were using a drug that was effective for their needs, rather than only those involved in clinical trials. It would thus be understood whether any contraindications associated with the drug would affect its final licensing approval. The academy did not recommend such a scheme, but as it discussed it, I thought that it would be an interesting matter to put to the Minister for further debate.
	Secondly, the academy referred to the importance of using European data. Of course, the sooner one arrives at a point at which a large population is using a drug, the more likely one is to identify adverse events that might occur. The academy refers to the need for an international co-ordinating centre on drug toxicity and the ability to undertake DNA sampling. The beauty of such an approach is shown by the fact that we increasingly find that drugs might be especially effective in circumstances in which people have a genetic predisposition. For example, Herceptin is likely to be effective for the 20 per cent. of women with breast cancer who are HER2-postive. Equally, there may be genetic predispositions towards adverse drug reactions, and we must focus as much on that possibility as on the positive opportunity to find drugs by understanding people's DNA responses. If we can do so, that will provide another positive benefit.
	My hon. Friend the Member for Southend, West made a good point about tuberculosis testing and the Mantoux test. If we are to have a NICE mechanism whereby the NHS undertakes evidence-based appraisals of clinical and cost-effectiveness to inform its clinical activity and priority setting, and if vaccines are available as alternatives to drugs and chemical compounds for the treatment of prostrate cancer and other cancers, I can see no reason why those vaccines should not be subject to NICE analysis. Indeed, that would have a positive benefit, as it would be more transparent. I have voiced the persistent complaint that the joint committee on vaccination and immunisation fails to give transparent advice. Its advice is subject to delay, and all the papers submitted to it are effectively invisible, because it is only the minutes of meetings that appear on its website several months after the meetings themselves are held. My constant plea is that we should have more transparency, as vaccines will become increasingly effective treatments.
	Another major issue raised in our debate is the take-up of drugs and the extent to which the NHS, through NICE, can access information about new drugs and their cost-effectiveness. My hon. Friend the Member for Windsor (Adam Afriyie) is right that there have been reductions in NICE funding, which has reduced the number of its appraisal committees from three to two at a time when their work load is increasing. For example, 29 new cancer drugs, a proportion of which will be fast-tracked, have to be submitted for appraisal. I shall not even consider the number of clinical guidelines that NICE should use, as it is important to focus on appraisals.
	We have urged Ministers to make good the reduction in NICE's resources, and I hope that the Minister will confirm that the Government will do so. The aim of the review of arms-length bodies associated with the Department of Health was not to cut bureaucracy but to try to focus resources on those that would be of the most value to people working on the front line in the NHS. The Health Committee emphasised the need for NICE to gain access to all the data accompanying licence applications to the Medicines and Healthcare products Regulatory Agency. As NICE will increasingly conduct appraisals alongside the MHRA, we may need to consider incentivising the acquisition of the appropriate data for NICE purposes while ensuring that companies are aware that they must produce data for MHRA licensing approval. Very often, those things happen in series, because the data required by each body are not the same. Companies are not sure whether NICE will make an appraisal, so any work that they undertake at an early stage may be costly and abortive. As the hon.   Member for Falmouth and Camborne (Julia Goldsworthy) said, they do not know whether Ministers will refer a drug to NICE, or whether there will be a delay.
	We need greater independence in the process of choosing what should be referred to NICE and when. For the purposes of appraisal and issuing clinical guidelines, I accept that it is Ministers' responsibility to determine what should be referred to NICE. The structure for the appraisal of new drugs should be straightforward and independent. If they are likely to be a cost-effective response to existing NHS requirements to provide treatment, should that not be communicated to the NHS as soon as possible after independent assessment?
	Herceptin was mentioned by the hon. Member for Falmouth and Camborne and others, and it raises significant issues. The hon. Member for Newport, West spoke about the speed with which drugs are taken up. As it happens, Britain is not a country where drugs are taken up with alacrity. In October the Karolinska institute published a report, with the benefit of financial support from Roche, which I none the less think is true, showing that although Britain has the highest level of direct cancer research, we have one of the slowest rates of take-up of cancer drugs in Europe.

Brian Iddon: Does the hon. Gentleman agree that the take-up of cancer drugs would be even slower if we did not benefit from translational research, where the clinicians work side by side with the scientists in wonderful institutes such as the Christie hospital and the Paterson laboratories in Manchester?

Andrew Lansley: Indeed. I have had the benefit of visiting the Christie hospital to see how translational research allows the whole range of cancer treatments to be provided in the same place, which is why, earlier this year, it was important to me to support the hospital in its argument that cancer surgery should not be transferred to another institution.
	I agree with the hon. Member for Bolton, South-East, not least because in the new year Cancer Research UK will open its largest UK research facility at Addenbrookes hospital on the Cambridge biomedical campus. There will be 600 dedicated cancer researchers in my constituency, who will be operating alongside clinical teams. That will not be just translational research. As time goes on it will be the closest that Europe gets to the National Institutes of Health.
	I know that the Government are proposing to create a virtual national institute for health research, but at the Cambridge biomedical campus we have everything from the laboratory of molecular biology doing world-leading blue-skies research at molecular level through to teams doing translational work. Professor Bruce Ponder at Addenbrookes hospital will lead the oncology teams for the Cambridge University Hospitals NHS Trust while also being director of the new Cancer Research UK unit, combining responsibility for clinical work with responsibility for academic work.
	We will not debate the availability of clinical academics, but if we do not reverse the recent decline in the number of clinical academics following the recommendations of Mark Walport's committee, it will be difficult for us to sustain the benefits of research. We talk about drug research, but if we are to translate that into benefits in clinical practice, we will need clinical academics, and the more of them we have, the more likely we are to retain the drug companies' commitment to drug development in the UK.

Brian Iddon: That is the very reason for the controversial move of the National Institute for Medical Research from Mill Hill into central London so that the excellent work on, for example, stem cell research that is done there can be brought closer to the clinics in central London.

Andrew Lansley: The hon. Gentleman keeps touching a raw nerve. I have corresponded with the Medical Research Council for some time on that matter. The working group that decided that the National Institute for Medical Research should be in central London rather than Cambridge because of the institute's international obligations was deluding itself. The work of the National Institute for Medical Research relates to the work of the institute of stem cell biology, which will be in Cambridge, and of the laboratory of molecular biology, which is in Cambridge, and I could go on.
	Although Cambridge university was not that fussedplenty of candidates want to be on the Cambridge biomedical campusit would have been justified in objecting, and I certainly felt that a peculiarly blinkered view was taken on where medical research can be carried out. However, University college and University college London will provide a fine home, and I will have nothing said against them. [Interruption.] I had to get there eventually. I also want to echo the remarks by the right hon. Member for Rother Valley about the importance of safety.
	We must decide whether we believe in the process that NICE undertakes. We cannot believe in NICE and the independent evidence-based analysis of what is clinically effective and cost-effective, and then simply throw the results out of the window. The right hon. Member for Rother Valley and I share that view on infertility treatments, because if one asks NICE to produce guidelines, one cannot suddenly pop up and say, Let's do something different.
	I acknowledge that Herceptin raises a completely different question. The matter does not rest with NICE, because the licence has not been applied for. That prompts the question on what basis is Herceptin being prescribed. I know the answer, because Cambridge university oncologists, who are convinced of its effectiveness, have written to me. Across the country, there are instances in which clinicians can prescribe drugs before licensing on the basis of their own judgment of emerging clinical evidence. However, that is a judgment by clinicians rather than by the Secretary of State or by a professional executive committee. Individual clinicians examine the data and take responsibility for such prescription.
	Before 2001, my predecessor, my hon. Friend the Member for Woodspring (Dr. Fox), suggested the creation of an exceptional medicines fund to help to accelerate the take-up of novel but potentially effective medicines in the NHS. I am not advocating that routeif we are devolving responsibility in the NHS, it is probably not appropriatebut it is one way to think about the problem. Even if we are devolving responsibility, we must examine, for example, the French system and understand more explicitly the circumstances in which such prescription should take place through the NHS. Perhaps we should involve NICE at an early stage in considering emerging evidence through clinical trials, even if the licensing process has not been completed. However, we should be aware that Herceptin, by its very nature, cannot be regarded as a precedent, and my party will not seek to use it in that way.
	The rest of the debate has concerned how we can support the industry while achieving effective self-regulation. Hon. Members disparaged the new code of practice promulgated through the ABPI, but we have to view these things with a bit of discretion. Frankly, if one sends a senior consultant who might be earning 150,000 to Kuala Lumpur, one can try to put him in a three-star hotel but I am not sure that he will stay there. Nobody has been expelled from the ABPI. However, I wonder whether we would conclude that the new standards and privileges arrangements brought into this House in recent years must be defective because nobody has yet been expelled. I am not sure if that is the right basis on which to judge such matters. [Interruption.] I am probably tempting the hon. Member for Newport, West again. Self-regulation is a better way to proceed. Let us ensure that we work with the industry. If we can see reasonable enhancements to the code of practice that are likely to have an impact, let us by all means propose them, but I heard no such substantive proposals today.
	We should think hard about how we support the pharmaceutical industry. We put an enormous burden on it as regards deciding where resources should go. An immense amount rests on its shoulders in terms of our futures. What would happen if those companies were to leave the UK? The disaster scenario would be GlaxoSmithKline deciding that it would be better off locating all its research and development activity in the United States. I do not suppose that it will happenI fondly hope not, touching wood. That would have enormous consequences for this country, not only economically but in terms of our whole research base.
	I want to mention two areas: first, NHS research and development activity; and secondly, the role of the pharmaceutical price regulation scheme. The Government's document, Best research for best health: A new National Health Research Strategy, confidently asserts:
	A summary of responses, including the next steps, will be published by 30 November.
	As it is now some time after that, this is an excellent opportunity for the Minister to tell us what conclusions have been drawn from the consultation so far. Since 1991, when a director was first appointed, NHS research and development has grown in its scope and ambitions. I am pleased about that.
	The additional five areas of clinical research networks will be terribly important, but we wait to see what scale of resources will flow into them. The clinical research network on stroke requires there to be corresponding levels of NHS research funding, because in comparison with cancer a very small amount of money is spent on supporting stroke research, notwithstanding that stroke is the third largest killer in this country and the major cause of adult disability.
	Creating a network therefore needs the resources to support it. I hope that NHS research and development will take seriously the possibility of accepting more responsibility for the costs of clinical trials so that the NHS is in a position to undertake a higher proportion of such trials with patients.
	The Under-Secretary knows that one of the major factors that differentiate five-year survival rates in Britain from those in, for example, France is the extent to which patients take part in clinical trials. The National Cancer Research Network was established in 2001 and the number of patients in clinical trials doubled but we remain some way behind France. Of course, we have only one national clinical research network. Clinical trials with patients should be conducted in the NHS. However, the costs of clinical trials in this country have doubled and the regulation has increased dramatically. I cannot dissociate myself from some of the responsibility for that because, when we considered the Human Tissue Bill, we added to the regulatory burdens. After many discussions with the Department of Health, we managed to reduce them, but they remain. The clinical trials directive and the Mental Capacity Act 2005 also added to them.
	Many people who work on clinical trials and try to set them up tell horror stories about the number of bodies that they have to approach to set up a clinical trial. They include funding bodies, local hospital research approval bodies, distant research and ethics committees, and data protection committees. The list appears endless. Approaching all those bodies is not only expensive but can provide a major disincentive to clinicians, whose time is valuable to them and to the hospital when deciding whether to devote time to clinical trials. We need more patients in clinical trials.
	Let me consider the pharmaceutical price regulation scheme. I made it clear before the election that, if we had the chance to do so, we would consider the range of matters that support a strong biomedical research capacity in this country. That includes the NHS research and development strategy and I am pleased that the Government have published a document about that. However, we should also consider the cost of clinical trials, which I have just mentioned, and the action that we can take against animal rights terrorists. The further legislation that the Government have proposed is right but the industry will tell them that it is important to ensure that there is a drive behind enforcement.
	We should consider the economic framework through the PPRS. Although the report is excellent, the Committee described the PPRS and made a passing reference to reform in the context of marketing allowance, which, in the grand scale of things, is trivial, but did not tackle the central question of the purpose of the PPRS and whether it is a fit-for-purpose scheme. I do not suggest that it is not fit for purpose and no one in their right mind would suggest simply abandoning it and letting the industry charge what it liked for drugs that have intellectual property protection.
	However, many other countries have alternative mechanisms and we need to consider carefully what happens on a European-wide basis. Too many other countries buy in a centralised system but benchmark themselves on an international basis and increasingly choose to benchmark their prices below the average. If that continues, one or two major marketsthe US and Japanwill overwhelmingly provide the profit to the pharmaceutical industry while Europe progressively reaches a point where it pays much less. That will not be a sustainable basis on which the industry can regard Europe as its second home for drug research and development. We must understand how to incentivise the conduct of research and development in this country in circumstances whereby we increasingly expose the industry to competition.
	I personally do not regard rate-of-return regulation as the right long-term solution, because it does not deliver genuine competitive pressures. The Government imposed a 7 per cent. cut, and no doubt that will deliver a reduction in the drugs bill. However, there is a lack of participation in the negotiations of the scheme by small drug companies and biotechnology companies, and this last review of the PPRS has exposed the way in which small companies, often those bringing just one product to the market, are severely disadvantaged. The big companies that negotiate the PPRS are able to change their prices between branded products; there is no real constraint in that regard. So if they have a competing product in a particular treatment area, they can respond through their price structures in ways that a small company with one product simply cannot.
	I still think that the PPRS provides an export disincentive. If companies are making major profits as a consequence of the exploitation of their drug in other markets, the price that they get from the NHS could be a disadvantage. There should be real incentives for exports, rather than disincentives. Although the research and development allowance went up, and although it can be an effective floor, I fear that it can also be a ceiling. Companies such as Pfizer have demonstrated the value of high levels of research and development activity in relation to their turnover, but our R and D allowance sets a benchmark and perhaps underplays the benefit of allowing companies to take a strategic option.
	The Office of Fair Trading is engaged in a review of these matters. I believe that the House, whether through the Select Committee or some other means, should examine the health and NHS purposes of the PPRS. I am an advocate of what the OFT does, and Members will recall that it quite rightly tries to drive towards competition outcomes. It needs to understand, however, what the health and NHS purposes of the PPRS are, in the course of its review.
	When the OFT considered the control of entry regulations in regard to pharmacies, it went away and thought about competition, and came up with a set of solutions. There was then a big row about the consequences because it had not taken fully into account the NHS purposes involved. Perhaps the answer is that we should derive all the competition benefits and, if the NHS wants other things, such as research, to happen, we might just have to pay more for that. Perhaps we should pay much more through the science and technology budgets to encourage companies to undertake their R and D here, and defray many more of the costs that they would otherwise meet.
	I am absolutely sure that because the PPRS is not a statutory schemeit is all voluntaryit is very difficult for us to get a handle on anything that happens in it. That is not necessarily because the Government and the industry are secretive; it is because there is no mechanism for the scheme to be examined. I am asking for a mechanismperhaps operated through the Select Committeeby which we can examine the fitness for purpose of the PPRS. We should do this over the next year, not in three years' time, when any such examination would become confused with the question of the negotiations. It would be better to examine in theory what the PPRS is intended to do, before we arrive at the next PPRS negotiations.
	Having said all that, I believe that the Select Committee has done an excellent job that has resulted in real, positive benefits in terms of the reporting of adverse events and the promotion of a new code of practice throughout the industry. I hope that the report will also lead to the more open and responsible use of clinical trial data and to the establishment of a scientific community that is able to give us a much better idea of what works and what does not, because we depend dramatically on the output of the industry.

Liam Byrne: I am grateful for the opportunity to respond to this excellent debate. I, too, congratulate former and current members of the Select Committee on its report. I should like to add my own words of praise to those of the hon. Member for Southend, West (Mr. Amess) about the Committee's former Chairman, David Hinchliffe. Mr. Hinchliffe was very generous with his advice to me after I got this job, and I hope to be able to benefit from some of it this afternoon. I want to put on the record my thanks and praise for him.
	My right hon. Friend the Member for Rother Valley (Mr. Barron) rightly began by saying that the House should be interested in an industry that develops new medicines from which we all benefit, and on which the national health service spends about 10 billion a year. Thousands of patients survive diseases such as cancer and coronary heart disease from which they would probably have died in the past.
	The industry is in no small part responsible for the extraordinary advances that the chief executive of the NHS was able to mention in his report, which was published yesterday. He was able to state, for instance, that over the past few years mortality rates for cardiovascular disease had fallen by more than 31 per cent., and that those for cancer had fallen by 14 per cent. I am sure that the whole House will wish to congratulate the staff of the NHS on the way in which they have harnessed our investment and reform to produce such remarkable results, with the help of Britain's pharmaceutical industry.
	My right hon. Friend presented an excellent summary of an excellent report, but before I respond to his points in detail, I want to deal with some of the points made by other Members. The hon. Member for Falmouth and Camborne (Julia Goldsworthy) is a direct beneficiary of some of the pioneering developments produced by the pharmaceutical industry. She referred to a number of issues involved in drug promotion, such as ghost-writing, regulation and Herceptin. I was pleased to learn of her concern about some of the future financing implications for the NHS. Fiscal rectitude does not commonly feature in Liberal Democrat speeches, but I welcome its emergence.
	The hon. Lady made an important point about inappropriate promotion of medicines. The MHRA can and does take action against the practice. She mentioned the inappropriate promotion of iPods. In that case the MHRA took action to stop the offer and require corrective statements to be made by the publication in which it appeared. Like a number of other Members, the hon. Lady mentioned the ABPI code. The code has been strengthened, but the key point is that it is underpinned by statutory controls, including criminal sanctions for breach of advertising regulations.
	My hon. Friend the Member for Newport, West (Paul Flynn) made an important contribution. His speech was well informed, well argued and backed by good evidence, asI have come to learnare all his speeches. He also spoke with great passion. He presented a powerful argument about the medicalisation of society. The Government made their position clear in the public health White Paper Choosing Health: making healthier choices easier. In the White Paper, we emphasised the need for the NHS to become a health improvement and prevention service. We are tackling that in a number of ways, putting health and prevention at the centre of our national service frameworks but also giving primary care trusts real means with which to tackle health inequalities and improve health.
	My hon. Friend highlighted a dilemma. On the one hand, speed is needed in the licensing of drugsmy right hon. Friend the Member for Rother Valley, in particular, mentioned thaton the other hand, there is the need for safety. In that context my hon. Friend cited Vioxx, with which I shall deal later. There are real conflicts and dilemmas, and it was right for my hon. Friend to draw our attention to them.
	The hon. Member for Southend, West made a fascinating speech. I cannot wait to see those photographs: I look forward to the arrival of the December edition of The House Magazine. He mentioned issues relating to the ABPI code, with which I shall deal in a moment. He also referred to NICE funding, MHRA statutory controls and industry sponsorship. Let me deal first with the NICE budgets, which were also mentioned by the hon. Member for Windsor (Adam Afriyie).
	The Government created NICE for a reason, and recognise the value of its work. Its contribution to the health debate has been extraordinary over the past few years. The NHS and international medical science have benefited from its work. Like all arm's-length bodies, however, it has been asked to make savings in its back-office and accommodation costs. We have taken great care to protect the budget for its core work: the budget for 200405 is some 30 million. We are confident that NICE can deliver its challenging work programme within the existing envelope of those resources. It is, of course, for my right hon. Friend the Chancellor of the Exchequer to consider future spending in the spending review that will start next year.
	The issue of statutory powers is important. From 1 January 2005, the MHRA has required pharmaceutical companies to provide all the evidence. The powers have always been robust, but the new requirement to notify the MHRA without delay of all new information impacting on risks and benefits is, I think, very important and the Select Committee will welcome it. Failure to provide such information is a criminal offence to which the sanction of unlimited fines and imprisonment applies. It was right for the Select Committee to highlight that matter. The new measures introduced from the beginning of this year will go some way to addressing some of its concerns.
	The hon. Member for Southend, West mentioned Herceptin, as did the hon. Members for South Cambridgeshire (Mr. Lansley) and for Windsor. As we know, it has received considerable publicity from our constituents and also in the media. The drug is already licensed for women with advanced breast cancer, but not yet for those with early breast cancer. As the hon. Member for South Cambridgeshire said, a number of oncologists have pointed to its quite extraordinary potential.
	It is already possible for clinicians to prescribe a drug outside licensing indications. It is then down to individual clinicians to decide whether it is suitable to prescribe a specific drug after discussions with patients, taking into account the potential risks, not least those suggested by the patient's medical history. Primary care trusts then have to be involved, as they have to decide whether to support a clinician's decision and supply the drug at NHS expense. They will have to take a range of factors, including the circumstances of the individual patient, into account in taking those decisions.
	The position that my right hon. Friend the Secretary of State sketched out is really threefold. At the momentpre-licence and pre-NICEit is for individual clinicians to consider with patients whether Herceptin is an appropriate course of treatment. Secondly, PCTs should not rule out treatment in principle, but should consider individual circumstances in taking their decisions. Thirdly, PCTs should not refuse to fund Herceptin solely on the grounds of cost.
	My hon. Friend the Member for Bolton, South-East (Dr. Iddon) made a number of important points about parallel trade. It is, of course, a legitimate trade that is allowed under EU law, but there are controls on it. If safety concerns arise out of parallel trade, I am sure that the MHRA will be keen to know about them and will subsequently investigate. My hon. Friend trained as an organic chemist, so I know that he is well qualified to comment about the risks in the process of counterfeiting. I completely agree that it is a growing concern. The MHRA is working with regulators worldwide to combat what is an international problem. Evidence at the moment suggests that incidence in the UK is low, and tools are in place, carrying criminal sanctions, to deal with it.
	We certainly cannot afford to be complacent about that problem, particularly in the light of growing internet sales. I completely share the concern of my hon. Friend the Member for Bolton, South-East about the potential risk to the public. Public and patients are well advised to exercise great caution in purchasing medicines on the internet. My hon. Friend will know that the MHRA has had considerable success in taking action against illegal internet sales, which has been extensively covered in the media this week. It remains a difficult area to police and the MHRA continues to find new ways of impacting on illegal sales. I am sure that, as the hon. Member for Broxbourne (Mr. Walker) suggested, that matter will benefit from our further attention on the Floor of the House.
	The hon. Member for Wyre Forest (Dr. Taylor) talked about many matters, particularly highlighting the need to align industry research priorities with NHS public health aims. As we are spending about 10 billion a year, that is not an unreasonable expectation. The Government found the Select Committee's conclusion extremely helpful. One of the ways in which we are taking its recommendations forward is through the UK's clinical research collaboration. As a first step, we have asked that a futures forum be held, to bring together many of the key stakeholders to advise Ministers on the future priorities for innovation in health care. The forum will be held in 2006 and it will be informed by the results of an ongoing strategic analysis of current research, funded by partner organisations. The pharmaceutical industry will be included, and the report will be available next spring.
	The hon. Member for Wyre Forest spoke about Vioxx with some import. Vioxx is an important part of the debate, particularly if we contrast the associated issues with those associated with Herceptin. There is a central dilemma and we are very grateful to the Committee for highlighting it. My questions, and those of other Ministers, are essentially the same as the Committee's. Why did pre-licence clinical trials not illustrate some of the problems? Were the trials long enough? Why did spontaneous adverse reporting not show up some of the problems post-introduction? As my hon. Friend the Member for Newport, West asked, what lessons can be learned to mitigate the possibility of such problems occurring again?
	Like Herceptin, Vioxx was seen as an incredibly important drug. It had the potential to provide an important level of pain relief and it did not have the side-effects associated with many existing drugs. The pre-clinical trials did not show up all the various problems and although there were differences with the placebo group, they were on a pretty shallow curve. Indeed, it can take up to 18 months for some of the side-effects to become apparent. That said, patients were obviously anxious for this new and potentially very valuable drug to come on to the market as quickly as possible. Adverse reporting was not going to help because many of the associated side-effects can be attributed to underlying patient conditions, such as heart disease and diabetes.
	Since then, an extremely important change has occurred. From the end of October this year, the licensing requirements for new drugs include the requirement for a risk-management plan, which must be agreed with licensing authorities. It can stipulate a range of requirements to monitor the effects and side-effects of new drugs, so for the first time, regulators have a degree of latitude in specifying, for example, the long-term clinical trials necessary in the new drugs field. That was an important issue for the Committee to highlight.
	The hon. Member for Wyre Forest also discussed the promotion of new medicines. The ABPI code now restricts promotion on the launch of new products, but to underpin that code the MHRA is vetting the advertising material for new drugs. However, we will monitor the new measures and if they do not deliver the change that the Committee and the Government are looking for, we will have to look again at the current controls.
	Expert advisory groups is another important issue that was raised. The Committee on Safety of Medicines will have expert advisory groupssome 14 of themand they are in the process of being appointed. As Members know, the Government adhere very closely to the Nolan principles, so the appointments being madefrom some 400 to 500 candidates and from every area of expertise, including lay memberswill take a little longer. In the meantime, however, the committee can call on the expertise of an external panel of experts in order to cover specialist areas.
	The hon. Member for Broxbourne, who has worked at the coal face of many of the issues that we have discussed today, raised the question of SSRIs, as did my hon. Friend the Member for Newport, West. The UK has gone further and has acted much faster in reviewing SSRIs than any regulator worldwide. The CSM's expert working group's report, which was published a year ago almost to the day, has been recognised as the most thorough review of a class of medicines ever undertaken. It resulted in new advicebacked by an unprecedented release of summaries of clinical trial datawhich was published alongside NICE guidelines. The MHRA continues to monitor the safety of selective serotonin reuptake inhibitors, and this week issued new advice on the use of Seroxat in pregnancy. I do not think that that is a record of complacency.
	I turn now to the points of substance contained in the Select Committee report, which my right hon. Friend the Member for Rother Valley spelled out with great eloquence. If I may, I shall take a slight detour through the vexed question of how many conclusions and recommendations the Government have accepted.
	From what I understand, the Select Committee report grouped a number of recommendations into one overall recommendation. The Government responded to all the recommendations, and to the sub-recommendations that they contained. Of the 32 recommendations, 26 were accepted in full or in part. I know that the Government response took some time, but the Committee took 10 months to write the report, and it was felt that the response needed proper consideration. After all, as my right hon. Friend the Member for Rother Valley said, this is the first such report for many years.
	My right hon. Friend the Member for Rother Valley raised various points, and I shall try to deal with each in turn. First, he asked about MHRA governance arrangements, an issue also highlighted by the hon. Member for Southend, West. When it was reviewed by the National Audit Office, the MHRAwhich was then known as the Medicines Control Agencywas found to be a major contributor to public health in the UK. That was a welcome finding, as was the assessment that it was a world leader in some respects, such as in the field of drug safety.
	The agency is tackling directly some of the issues raised in the NAO report, and the Government response strongly welcomes the Select Committee's suggestion that there should be a further review once current reforms have bedded in. In addition, and as is to be expected, Ministers continue to monitor the MHRA's performance. The agency has been strengthened by the adoption of many new internal controls of its own, which will ensure that the agency remains independent and its staff free of conflict.
	Nevertheless, I welcome the suggestion from my right hon. Friend the Member for Rother Valley that the House should monitor the agency's progress closely. I am sure that his proposal that the House and the Select Committee should provide input in respect of the review's terms of reference will be of great interest to my right hon. Friend the Secretary of State.
	As part of the ongoing reform process, the MHRA recently revised its medicines advisory committee structure. The Commission on Human Medicines came into being on 1 November. It is not a direct result of the Select Committee report, but it does deal with some of the issues raised in that report. For example, each advisory committee now contains two lay members, to ensure that wider judgments are made about risk benefit as well as about medical and scientific matters. Importantly, the new structure allows the patient voice to be heard in the regulatory process, and the rules on the interests of committee members have also been strengthened. As a result, the new committee's chairman and members will not be allowed to hold financial interests in the pharmaceutical industry.
	My right hon. Friend the Member for Rother Valley also raised issues to do with promotion and industry information, both pre and post-licensing, and six or seven points are relevant in that context. First, since the Government's response was published, much progress has been made on ensuring high standards in the promotion of medicine. For instance, initial advertising is now vetted before publication.
	Secondly, the agency has delivered on its commitment to agree a memorandum of understanding with the prescription industry's self-regulatory body, which was published last month. Thirdly, and as the hon. Member for South Cambridgeshire pointed out, the ABPI code has now been strengthened.
	Fourthly, a great deal of progress has been made in improving the quality of patient information, about which the hon. Member for Wyre Forest spoke most cogently. I have not had the benefit of visiting Australia to see how matters are handled there, but if I behave myself that opportunity may be afforded me at some time in the future.
	The issue of promoting information to patients is important, especially in a world in which, as my hon. Friend the Member for Bolton, South-East (Dr. Iddon) mentioned, people are beginning to buy products on the internet. The new requirement for user testing of information in patient information leaflets came into force in the UK in July, ahead of the time frame in European law. That will deliver potentially the most powerful tool to ensure that the needs of patients are properly met. In the same month, the expert group of the Committee on Safety of Medicines published its report, Always read the leaflet, with new guidance on user testing, risk communication and, importantly, the usability of patient information leaflets.
	The fifth measure was on the safety monitoring of medicines, to which many hon. Members referred. As my right hon. Friend the Member for Rother Valley mentioned, patients and members of the public have been able to report suspected adverse drug reactions through the yellow card scheme since January 2005. Since then, around 750 yellow card reports from patients and members of the public have been received. Since the Committee reported, the UK-wide patient reporting pilot was launched in October, developed on the basis of considerable engagement with stakeholders, and supported by a major promotional campaign.
	The sixth area, which many hon. Members on both sides of the House will welcome, is the registration of clinical trials. The Health Committee argued in favour of the registration of all clinical trials and the publication of the results of trials. The Government largely accept that argument. We fully support the case for transparency and accountability, and we are working nationally and internationally to get the principles applied in practice. A number of important developments have taken place in the past year, and it is now clear that the movement towards registering trials and providing much better public access to research evidence about safety and effectiveness is unstoppable. Much of the momentum comes from a shared aim of the Government and the industry to build public confidence. International pharmaceutical industry associations have made public commitments, which have been strengthened by the understandings in the UK. At the same time, the World Health Organisation is working on standards for trial registration and international agreement on systems to give easy access to information, and the European Medicines Agency is about to launch a public database called EuroPharm. We very much welcome all those developments.
	To go further, however, the Government strongly support more openness and transparency in the regulation of medicines. The MHRA is making good progress in that field, as we highlighted in our response. A communication strategy is now in place, which considers how we raise the profile of the agency and increase the understanding of medicines-related issues among the general public. In our published regulatory information, all newly licensed programmes will be accompanied by a UK public assessment report, which will be posted on the MHRA website. The agency also regularly publishes summaries of clinical trial data to support key communications on drug safety, along with all details of adverse drug reactions.
	Several Members, such as the hon. Member for Falmouth and Camborne and my right hon. Friend the Member for Rother Valley, mentioned the report in The Observer a week or two ago about the alleged case of research misconduct involving a comparative study of two drugs for the treatment of osteoporosis. The MHRA is investigating that at the request of the chief medical officer. The aim of the investigation is to establish whether there has been an abuse of the regulations governing clinical trials, but it will also seek to establish whether legislation requiring companies to submit immediately to the MHRA any new information that might affect the risk-benefit balance of the product has been breached. The Government view that as a very serious matterfalse research can lead to the wrong treatment being given.
	For academics who might be involved, who are not part of a profession, criminal sanctions are not yet available. At the moment, we rely on employers to take action. That is why we warmly welcome Universities UK's initiative in setting up a UK panel for research integrity in health and biomedical science. One of its functions will be to help research employers, including universities, the NHS and industry, to take effective action against allegations of scientific misconduct.
	My right hon. Friend the Member for Rother Valley, in his concluding remarks, highlighted the need for speed in introducing drugs to market. That is something that is being addressed in part through the ministerial industry steering group, which brings together leaders from the pharmaceutical industry and Ministers to consider issues that might impact on the industry. One of those issues is how regulation can be adopted to accelerate the pace of introduction of new drugs to market, including what kind of controls are needed and how can we gather safety data to avoid scares such as the withdrawal of Vioxx. We have to keep in mind the balance between public safety and the difference that new drugs can make.
	The issue of NICE is part and parcel of that. I have dealt with the question of its funding and it is now out to public consultation on fast-track assessment on single therapies. Those assessments will sit alongside full appraisals. NICE is now prioritising its work plan to ensure that new needs are met.
	I welcome much of the Committee's report, but I also welcome much of what the hon. Member for South Cambridgeshire said. He was right, in particular, to say that connecting for health has extraordinary power to help. I know that I am not supposed to say this in the new mood of consensus that has broken out on the Floor of the House, but connecting for health is not free. Its future rests on investmentthe kind of investment that is precluded by policies such as the patient's passport. After the events of the past two days, I look forward to hearing about its future.
	We have had a useful, lively debate this afternoon. The pharmaceutical industry brings enormous benefits to this country, to patients and the NHS and to the economy.

Andrew Lansley: If we are going to break the consensus, I shall ask the Minister this question. The Prime Minister at one point pledged that 1.5 per cent. of the NHS budget would be devoted to research and development. When will that happen?

Liam Byrne: I am sorry to see that the consensus has collapsed as quickly as a souffl. I do not have the precise figures on research and development in front of me, but I shall be delighted to write to the hon. Gentleman with the details of NHS research and development. It is an issue of great importance not only to the NHS, but to the country, which is why my right hon. Friend the Chancellor announced such bold proposals to increase funding in that area by, potentially, more than 1 billion over the next few years.

Andrew Lansley: rose

Liam Byrne: No, I must conclude, because I know that my right hon. Friend the Member for Rother Valley is waiting to respond to the debate.
	It is important that the relationship between the health service, the Government and the pharmaceutical industry is transparent. It is also important that continued investment goes into new drugs. Those drugs will be vital as we put record investment into the NHS over the next two or three years so that we can continue to make the advances that we have made in the battle against big killer diseases.

Kevin Barron: May I first say to the House

Mr. Deputy Speaker: Order. The right hon. Gentleman should ask for the leave of the House to reply to the debate.

Kevin Barron: With the leave of the House, I wish to reply to the debate. I thought that the Whips had more influence on the debate than they have.
	It was remiss of me not to say that the report was brought together and put before the House under the chairmanship of David Hinchliffe. Many hon. Members have said what I should have said at the beginning, but I shall say it now. David was a well-respected Chair of the Health Committee and I hope to be as helpful to the House and, on occasions, to our Front Benchers, as he was. I agreed earlier today to have lunch with David before Christmas and I will pass on everybody's good wishes, as well as a copy of Hansard to digest along with his turkey and whatever else he has at Christmas.
	I thank the hon. Members for Southend, West (Mr. Amess) and for Wyre Forest (Dr. Taylor) who went to Australia on behalf of the Committee. They have been to Dublin with me, which may be a reflection on me as Chairman. They took part in a long investigation and I am pleased that they have been here this afternoon.
	My hon. Friend the Member for Newport, West (Paul Flynn) mentioned all-party groups. Had this debate taken place six weeks ago, I would have had to declare that I was the chairman of the all-party group on the pharmaceutical industry, which I was for eight years. I gave that up because of the position I now hold, although I will remain a member.
	My hon. Friend the Member for Newport, West will know that the ABPI provides the secretariat of the all-party group. In all the years that I have had dealings with the ABPI, I never thought that it was trying to get me to come here and argue its case. If that is what it was after, it failed quite miserably in many areas. But over the years it has given me, and many other hon. Members of this House and the other place, the opportunity to discuss issues relating to the industry, whether animal testing or any of the other things that have happened. We were able to question it and the professionals involved on issues related to what is, and will always remain, I hope, a very important sector of the British economy and an industry that looks after the health of many hundreds of thousands of people.
	Over many years, as my hon. Friend the Under-Secretary said, the ABPI has played a key role between different Governments and the pharmaceutical industry, making sure that the industry remains a healthy part of the economy and at the forefront of European research and development.

Andrew Lansley: Doctors attend many industry-sponsored conferences, meetings, dinners and events, including those supported by drugs companies. Their integrity is no less than ours and my experience is that they are not in the least affected by who their sponsor or supporter might be.

Kevin Barron: That is my experience as well.
	I declared that I am a lay member of the General Medical Council, the regulatory body for doctors. I was at the GMC on Tuesday on Euston road and had an exchange of letters with the chief executive about this debate. I was not able to have a long discussion with him, but he wrote to me on the recommendation to keep a register of members' interests, for want of a better expression.
	There are about 230,000 doctors registered with the GMC and we think that about 130,000 have an active role. Many have retired but remain on the register, as that was a big part of their professional career and they would like to keep their names on the register. The chief executive, Finlay Scott, said that the GMC as a regulatory bodyunlike the Royal College of Nursing, which is a membership association, or trade union, for want of a better expression, without the GMC's statutelays down conditions under which doctors have to work.
	The publication Good Medical Practiceoften described as the doctors' bibleclearly states what doctors should and should not be doing. The chief executive reiterated the section to me:
	You must act in your patients' best interests when making referrals and providing or arranging treatment or care. So you must not ask for or accept any inducement, gift or hospitality, which may affect or be seen to affect your judgment. You should not offer such inducements to colleagues.
	If doctors breach those rules, they go before a fitness to practice committee, with the likelihood of action being taken against themthey could even be struck off the medical registerbut that has not happened during my six years' experience of serving on the GMC.
	The new ABPI code of conduct has been mentioned. The ABPI is a trade organisation that works well with the Government, but it is not a statutory body and therefore cannot issue statutory codes. Given all that is said about Members of Parliament enjoying BA upgrades, kettles calling pots black come into mind, so I shall move on from that because a lot has been said about patient safety and drug efficacy that does not hold water.
	I shall briefly deal with what the hon. Member for South Cambridgeshire (Mr. Lansley) said about the PPRS. Paragraphs 113 to 120 of the report explain in reasonable detail what the PPRS does. That is the most transparent translation of the PPRS that I have seen in over a decade of being involved in one way or another in the House with the pharmaceutical industry. We have gone about as far as we can go with the PPRS. If we were to make it totally transparent, the companies would be looking over their shoulders asking why one of them receives more on one scale and less on another than the others.
	The PPRS is not the most transparent scheme and it is not a statutory one. The Government and the industry sit down together, and they have recently reached another decision that will benefit the NHS, inasmuch as they agreed that more money will come from it. I am not tempted by the suggestion to take a further look at the PPRS that was made by the hon. Member for South Cambridgeshire. I may have to be tempted by members of the Committee if they decide that we should take a further look at it. However, making the scheme more transparent would probably destroy something that no one argues is detrimental to their case. I have spent a decade visiting pharmaceutical companies and having dialogue with them, and I have never yet met anyone with any weight in the pharmaceutical industry debate who says that we should get rid of the PPRS.

Andrew Lansley: I have not suggested getting rid of the PPRS either, but irrespective of whether the right hon. Gentleman thinks that there should be greater openness about the PPRS, frankly, the Office of Fair Trading will ensure that that happens. I was particularly concerned about the fact that past experience has demonstrated that the OFT will do a thorough job on the competition aspects, but it is very important that the Department of Health, the House or somebody thinks very hard about the NHS aspects.

Kevin Barron: If the OFT drives that, it will happen. The report suggested that the Department of Trade and Industry, not the Department of Health, should be the sponsoring Government organisation, but the Government did not agree with that either. I have some sympathy with the Government's response, because we get a lot more via the PPRS than we would if accountants considered the industry on the basis of how many pounds it is worth to the United Kingdom. The OFT may take us down that road, but we will have to wait and see. If it does so and the Government respond, the Health Committee will consider what should replace the scheme, but it has great benefits.
	I visited Pfizer about 10 years ago and was shown the big second phase of its research and development in the UK. The company beat off Pacific rim institutions to bring that work to this country. We chatted about the UK's science base and what our universities were delivering at that time. Why did Pfizer want to come to this country and invest such massive amounts of money, especially on the north Kent coast? It is not the most attractive place on earth. Apologies to the people who live therethey would probably think the same about my home town. There are reasons why the UK has been so successfulas successful, if not more so, than most European countriesin attracting inward investment for research and development over recent decades and the PPRS has something to do with it, although what is happening with the OFT may overturn that.
	Some people argue that the scheme is wrong. People who are not aware of the full R and D picture might think that small manufacturers, for example, would be better off without the PPRS, but I think that it is of great benefit. It is no coincidence that the pharmaceutical sector is the third largest in our economy. We shall see what the future brings, but that is my feeling at present. As well as the PPRS, the industry has much wider engagement with the Government.
	I thank my hon. Friend the Minister for what he said about the contributions to the debate. Like other Members, I pointed out the numerous aspects of the pharmaceutical sector on which the Health Committee will keep a watching brief over years to come. We shall also look at the Government's responses.
	The debate has not been well attended, but the quality of the contributions and the knowledge of the participants on both sides of the House has been excellent. It shows the House and, I hope, the Executive what the Select Committee system can do to assist us in our deliberations on behalf of the nation. Parliament and the Executive can work closely together and Parliament can advise the Executive through the work of Select Committees. I hope that my hon. Friend's positive approach to some aspects of the debate will extend to the Select Committee's reports and recommendations in the not too distant future.
	Debate concluded; Question deferred until Six o'clock, pursuant to Standing Order No. 54 (Consideration of estimates).
	Sitting suspended.
	On resuming
	It being Six o'clock, Mr. Deputy Speaker proceeded to put forthwith the deferred Question, pursuant to Standing Order No. 54 (Consideration of estimates).

VOTE ON ACCOUNT, 200607

Resolved,
	That, for the year ending with 31st March 2007, for expenditure by the Department of Health
	(1) resources, not exceeding 27,595,662,000, be authorised, on account, for use as set out in HC 465, and
	(2) a sum, not exceeding 26,808,818,000, be granted to Her Majesty out of the Consolidated Fund, on account, to meet the costs as so set out.
	Mr. Deputy Speaker proceeded to put forthwith the Questions relating to Estimates which he was directed to put at that hour, pursuant to Standing Order No. 55 (Questions on voting of estimates, c.).

SUPPLEMENTARY ESTIMATES, 200506

Resolved,
	That, for the year ending with 31st March 2006
	(1) further resources, not exceeding 3,183,848,000, be authorised, for use for defence and civil services as set out in HC 672,
	(2) a further sum, not exceeding 4,677,710,000, be granted to Her Majesty out of the Consolidated Fund, to meet the costs of defence and civil services as so set out, and
	(3) limits as so set out be set on appropriations in aid.

ESTIMATES, 200607 (VOTE ON ACCOUNT)

Resolved,
	That, for the year ending with 31st March 2007
	(1) resources, not exceeding 144,195,341,000, be authorised, on account, for use for defence and civil services as set out in HC 465, HC 467, HC 468 and HC 469,
	and
	(2) a sum, not exceeding 134,448,075,000, be granted to Her Majesty out of the Consolidated Fund, on account, to meet the costs of defence and civil services as so set out.
	Ordered,
	That a Bill be brought in on the foregoing resolutions: And that the Chairman of Ways and Means, Mr. Chancellor of the Exchequer, Mr. Des Browne, Dawn Primarolo, Mr. Ivan Lewis and John Healey do prepare and bring it in.

Consolidated Fund Bill

John Healey accordingly presented a Bill to authorise the use of resources for the service of the years ending with 31st March 2006 and 31st March 2007 and to apply certain sums out of the Consolidated Fund to the service of the years ending with 31st March 2006 and 31st March 2007: And the same was read the First time; and ordered to be read a Second time on Monday 12th December, and to be printed [Bill 101].

DELEGATED LEGISLATION

Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Standing Committees on Delegated Legislation),

National Health Service

That the draft National Health Service (Dental Charges) Regulations 2005, which were laid before this House on 22nd November, be approved.[Vernon Coaker.]

Mr. Deputy Speaker: I think the Ayes have it.

Hon. Members: No.
	Division deferred till Wednesday 14 December, pursuant to Standing Order No. 14A (Deferred divisions).
	Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Standing Committees on Delegated Legislation),

International Immunities and Privileges

That the draft International Criminal Court (Immunities and Privileges) Order 2005, which was laid before this House on 23rd November, be approved.[Vernon Coaker.]
	Question agreed to.

EUROPEAN UNION DOCUMENT

Motion made, and Question put forthwith, pursuant to Standing Order No. 119(9) (European Standing Committees),

Return of Illegal Immigrants

That this House takes note of European Union Document No. 12125/05 and ADDs 1 and 2, Draft Directive on common standards and procedures in Member States for returning illegally staying third-country nationals; and recognises the Government's specific policy, security, legislative and financial concerns in deciding whether to opt into this Directive.[Vernon Coaker.]
	Question agreed to.

DELEGATED LEGISLATION

Ordered,
	That the Travel Concessions (Extension of Entitlement) (England) Order 2005, (S.I., 2005, No. 3224) dated 22nd November 2005 be referred to a Standing Committee on Delegated Legislation.[Vernon Coaker.]

MULTIPLE ROAD TRAFFIC OFFENCES

Motion made, and Question proposed, That this House do now adjourn.[Mr. Coaker.]

Andrew Selous: I am especially grateful to Mr. Speaker for granting me this Adjournment debate, which deals with serious issues of public safety. I hope that the Minister will realise how serious these matters are, and that in his response he will be as positive as possible about how to deal with them.
	The problem of multiple road traffic offences, which involves vehicles registered at false or incorrect addresses, has been brought to my attention by a number of my constituents. Vehicles that they have never owned and about which they know nothing have been registered at their addresses, with the result that the police have been in contact with them on many occasions.
	I want to pay tribute to Bedfordshire police for their persistent action to try to deal with this problem, and specifically to PC Sean Quinn and PC Graham Dunn, who have worked tirelessly on behalf of the people of Bedfordshire in that regard.
	The problem, in essence, is the police's complete inability to prevent and successfully prosecute repeated road traffic offences of an extremely serious nature. Let me give some examples.
	In the case of excessive speed, I have recent documented examples, with photographic evidence, of drivers doing 98 mph in a 50 mph limit, 117 mph in a 50 mph limit at night, 73 mph in a 30 mph at night, and 82 mph in a 30 mph limit in the middle of Dunstable, a major town in my constituency. The highest recorded speed that has come to my attention was of a vehicle doing 119 mph in a 50 mph limit, on 4 September this year on the A505 between Leighton Buzzard, Dunstable and Houghton Regis in my constituency. As I shall explain shortly, such vehicles have been doing those sorts of speeds in those conditions time and again.
	There is a problem not just with speed, but with vehicles jumping red lights, in some cases up to six seconds late. We know that one vehicle has done that on nine separate occasions, but the police are powerless to do anything about it. The reason that the police are powerless is, as I said, that vehicles are incorrectly registered to false addresses, or cloned, whereby a vehicle of a similar description to that which the perpetrator wants to register to a false address is registered to a law-abiding person's address. Farmers are often coerced into having their property used as a false postal address. One property in Chelmsford25 Duke streetis notorious among not only Bedfordshire police but Essex police. I understand that it is no more than a drop-off postal address at which many vehicles are registered, apparently legally, but the police have no ability to contact the owners or do anything about the perpetrators of such offences.
	As well as excessive speeds and going over red lights, there have been examples of extremely dangerous driving, such as people driving with their hands over their face at 64 mph at night, people taking their hands completely off the wheel even at night in a 30 mph zone, a child in the front seat on an adult's lap with no seat belt, and many offensive gestures made by drivers of vehicles at cameras. In the village of Kensworth in my constituency, which has a speed camera, a photograph was taken of a driver with one hand on the wheel while giving a thumbs up gesture out of the window to the camera with the other. All three other adults in the car are grinning at the camera. That shows that people who behave in such a way know that they can break the law, are flaunting their law-breaking and are taunting the police, who, they know, are powerless to act.
	The Minister will agree that the danger to the public from the examples that I have given is huge. How would he like people driving in that manner to come close to the vehicle in which he was travelling with his family?
	The problem is significant, and the incidents are not isolated. As at 7 April this year, the police have evidence of 1,004 such offences in south Bedfordshire alone. Of those, 466 were current and due to have fines paid of just under 28,000, and 538 offences were lost under the six-month rule, so the police had no ability to recoup more than 32,000 of fines that will not be paid. Therefore, there is also a public expenditure implication, and I am sure that the Minister would want all fines that have been properly levied to be paid and to come in to the police.
	The powers that are needed to do something about this problem are as follows. The police need to be given the ability to seize a vehicle that is incorrectly registered and involved in multiple offences. The police should then have the power to retain that vehicle until the owner or offender is correctly identified and, if necessary, to dispose of the vehicle by suitable means, not least to pay off any fines levied on it. The police also need a further power of entry to land and/or garagesnot dwellings, as people obviously do not keep cars in their housesto seize such vehicles.
	As I said, these are repeat offences. Moments before the debate, I was told that one van still on the road in South Bedfordshire has just clocked up its 73rd offence and a motorcycle has clocked up 61 offences. When I say multiple offences, that is the order that I am talking about.
	Bedfordshire police have done their homework on this issue and visited the Home Office on 15 April. I understand that it was suggested to the police that section 59 of the Police Reform Act 2002 should be sufficient for them to be able to address the problem. Bedfordshire police then contacted another five police forces to discover whether they were in the same position of not being able to apply section 59 in practice on the ground. Thames Valley police replied:
	To have power to seize vehicles showing multiple offences, if granted, would indeed be a useful tool in increasing road safety, if the safeguards required did not blunt its effectiveness . . . I can say that we rarely use the Police Reform Act because of the frustrations put upon us by the control room.
	Suffolk police replied that
	it could also be extended to cover vehicles owned by foreign nationals. We have a serious problem with transient workers in the food processing industry. They use a single base address to register their vehicle and then quickly move on.
	Greater Manchester police said that they had
	asked our force solicitor re anti-social behaviour and serving a notice on the owner/driver of multiple offenders (concerning seizure). The Solicitor's response has deemed the act inappropriate in this case.
	Cambridgeshire police replied:
	I would see seizure of vehicles could be promoted as a major contribution to road safety, in getting the cars out of circulation, even though temporarily.
	And Essex police replied:
	I am not aware of any forces using the Police Reform Act for repeat offenders of camera activations, and there does not appear to be any other legislation that may assist.
	I understand that it has also been suggested that section 43(c) of the Vehicle Excise and Registration Act 1994, which was put in place by the Serious and Organised Crime and Police Act 2005, has been suggested as a means of dealing with the problem, but I am again reliably informed by the police that that is not the case because that provision deals purely with driving without a valid driving licence and driving without insurance. Most of these vehicles are driven by people with licences and most are insured, so that legislation would not do the job that is required.
	I tabled a parliamentary question on this issue recently to ask the Secretary of State to make a statement on the effect of the registration of false vehicle licence addresses on the ability of the police to combat multiple road traffic offences. The Under-Secretary of State for the Home Department, the hon. Member for Wythenshawe and Sale, East (Paul Goggins), replied:
	An accurate register is important for identification purposes, so that the police can take effective action against the perpetrators.
	The problem is that we do not have an accurate register. He continued:
	we have strengthened the likelihood of accuracy by the introduction of continuous registration and by creating a new offence of using a vehicle that is incorrectly registered.[Official Report, 5 December 2005; Vol. 440, c. 968W.]
	That power does not give the police the powers that they need to do the job.
	In a letter to me dated 21 November, the Driver and Vehicle Licensing Agency stated:
	It is essential therefore that information about vehicle keepers on the register is both accurate and up-to-date but we are very much reliant on the public and the motor trade to provide this information.
	It said that the information is used to
	assist with road safety, law enforcement and the collection of vehicle excise duty.
	I hope that I have outlined the scale of the problem and how serious it is. It is not a party political matter. What can we do about it? The Minister will know that the Road Safety Bill is about to arrive in this House. I have looked carefully at the Bill with Bedfordshire police and I suggest that it should be possible to amend clause 15the clause deals with speeding, but we need to look at red-light issues and at dangerous drivingon the power to seize, retain and dispose of vehicles. Could we insert in clause 36 a requirement to prove one's address when a vehicle is registered? I know that the Government have looked at this and decided not to go down that route, but given the scale of the problem in my area alone, will the Minister agree to take the issue back, perhaps to a joint working party between the Home Office and the Department for Transport, and look at it again to see whether utility and council tax bills, or documents of that nature, should be required?
	Above all, this is a crime prevention measure. I would argue that, if we get these measures on the statute book, we would rarely need to use them because the deterrent would be such that the word would go out that the police had the necessary powers. People would comply and the problem would disappear. I look forward with eager anticipation to the Under-Secretary's reply.

Andy Burnham: I congratulate the hon. Member for South-West Bedfordshire (Andrew Selous) on securing the debate. He began by saying that it raised serious issues of public safety and I agree. Only last week at my advice surgery, I was dealing with a case of death by dangerous driving of a teenage boy in my constituency. I agree with the hon. Gentleman that this is not a great party political issue. Members on both sides want the police to have adequate powers to tackle irresponsible driving, which poses a danger to all of our constituents. There is a common purpose in wanting that to happen.
	I welcome the spirit in which the hon. Gentleman introduced today's debate. Our responsibility is to ensure that the legislation on the statute book deals adequately with the problem, but is also proportionate. We believe that that is the case. He said at one point that the police were powerless to act. I hope that I can convince him that that is not the case and that the police do have powers to act. We keep those powers under review, but they are proportionate and balanced.

Andrew Selous: I have just told the Under-Secretary that six different police forces in different parts of the country have said that, for all sorts of practical reasons that affect police forces on the ground, the powers currently on the statute book are not adequate. He will no doubt tell me what legislation there is on the statute book, but will he address those specific concerns raised by six police forces?

Andy Burnham: The hon. Gentleman will know that we have changed the law in a number of ways in recent years in respect of irresponsible and dangerous driving, vehicle keeping and the powers that the police have to seize vehicles. The Home Office has received advice from the Association of Chief Police Officers that many forces are using the section 59 powers extensively and effectively. I heard the comments from the forces that the hon. Gentleman read out, but some 43 police forces have told us that those powers are being used and that they are very welcome in tackling antisocial driving.

Andrew Selous: I have given the Under-Secretary an illustration from my constituency, where there have been 1,004 offences. I can assure him that I have extremely good officers in Bedfordshire who are desperately keen to enforce the law. They are not stupid people; they are very bright and follow the law very carefully. Why are they unable to use the current law to deal with a situation where one vehicle has 73 offences charged to it and where there are 1,004 in total?

Andy Burnham: Of course I was listening carefully to the comments that the hon. Gentleman read out. We would want to work through those issues with the forces concerned, and I will refer to some of the detailed advice on the issue that we have recently given to forces. I do not doubt for a second the committed efforts of the officers whom he named during his speech and the general efforts of Bedfordshire police. He also mentioned my police forceGreater Manchester policeand I face issues in my constituency similar to those that he described, and I would want to pursue them with the force from my own perspective. I assure him that the advice that we have received via ACPO is that the powers are welcomed and that they are being used. If there are problems in certain areas, it is important that we work them out. We have a common interest in ensuring that the powers that the police have at their disposal are used.
	I want to read out a comment from the hon. Gentleman's website with which I wholeheartedly agree. He gave notice on his website that he would seek a change to the Road Safety Bill that will soon come before us, but he also said:
	I would like the government to concentrate on enforcing the laws we have on the statute book, rather than continually passing new laws.
	That is absolutely the right position with regard to this issue, and the important thing is to focus on fully implementing the laws that we already have.
	Let me set out some of the background. The hon. Gentleman will know that the roads policing strategy statement was issued jointly by the Home Office, the Department for Transport and ACPO in January and that reducing the antisocial use of the roads is one of the five specific actions on which the statement envisages that roads policing should focus.
	Before I deal with some of the specific issues that the hon. Gentleman raised about seizure and the use of false addresses, I want to stress that the key to enforcing the law is ensuring that we have an accurate vehicle register. He is right to focus on that. Vehicles that are registered with incorrect details or not registered at all are regularly used in criminal and antisocial activities. They are often subsequently abandoned or burnt outI am sure that he has experience of those problems, toowith further costs to local authorities. For the police to track and take effective action against the perpetrators, there must be an accurate register for identification purposes. It is an offence not to supply the relevant details for correct registration, but, of course, we cannot rely just on the willingness of the people who behave in that way to comply with the law. That is why we steadily strengthened the accuracy of the register.
	A major step forward was the introduction of continuous registration, to which the hon. Gentleman referred and under which the registered keeper of a vehicle has statutory responsibility for licensing it and retains that responsibility until the DVLA is informed that the vehicle has been sold, exported, stolen or scrapped, or that a valid statutory off-road notification has been made. The registered keeper is therefore responsible for requirements in respect of the vehicle, such as the payment of vehicle excise duty, and cannot now evade them by claiming no longer to be the keeper. The DVLA also takes steps to ensure that false addresses are not accepted. I was listening carefully to the hon. Gentleman when he mentioned an address in his constituency that was regularly used to register vehicles falsely.

Andrew Selous: The address that I mentioned was 25 Duke street, Chelmsford, which is some way from my constituency, but it is well-known to the Essex police. It is curious that a number of vehicles in Bedfordshire are registered at that address. Will the Minister tell the House whether he thinks that the current laws on vehicle registration are adequate, given the problems that I have outlined? I am aware that the Government have gone further recently in that respectof course that is welcomebut the proof of the pudding is in the eating. Is the law working and helping the police to do their job?

Andy Burnham: That is an important point. I hope that the DVLA will read in Hansard the hon. Gentleman's comments about that address and be able to take some action.
	I can assure the hon. Gentleman that a procedure introduced in October 2004 means that known temporary addresses, addresses of convenience or post office box numbers are not acceptable for vehicle keepership details. When he introduced his remarks, he referred to strengthening the identity checking procedure when a vehicle is registered and he asked whether a utility bill or council tax bill could be used for that purpose. A utility bill does not prove much, however, and as the Minister responsible for identity cards and the national identity register, I urge the hon. Gentleman to think again if he, like his party, still opposes those measures. Linkage with the national identity register could bring real benefits in maintaining an accurate vehicle record. The register is a much higher proof of identity than a utility or council tax bill.
	Under a procedure introduced in January 2004, the DVLA undertakes identity checks for high risk vehicles, such as those that are being imported. The checks cover both the vehicle and the prospective keeper. A database of all vehicles with no confirmed keeper is available to the police and can be checked by their automatic number-plate recognitionANPRcameras. Once a suspect vehicle has been stopped, the police have access via the police national computer to the full drivers' database to help establish the identity of the driver. The system is being improvedI can assure the hon. Gentleman that we constantly look to improve itso that the police will have direct access to drivers' details through a handheld device. Trials are scheduled for spring next year, and from 2007 we expect the photographic image to be available through those devices in respect of drivers holding a photocard driving licence.
	We think that will be a significant step forward. It will support the already increased roadside enforcement through greater use of police ANPR cameras and through the DVLA's powers, working with local authorities, to wheel-clamp and crush unlicensed vehicles.
	In the remaining time for the debate, I want to discuss police powers on seizure, which is an important point and one that the hon. Gentleman wanted to cover.

Andrew Selous: The Minister is being generous in giving way and I appreciate his doing so.
	If the Minister's case in the remainder of the debate is that the current powers are adequate, can he give me a simple, clear explanation why Bedfordshire police have been unable to do anything about that one vehicle that has 73 serious offences recorded against it? That is the fundamental question. If the law is adequate, why have the police been unable to anything about that?

Andy Burnham: I cannot discuss that case as I do not have the details, but if the hon. Gentleman will allow me to explain the law as it stands perhaps we can agree or disagree about whether the current position is adequate. New legislation is not always necessarily the answer; indeed, the hon. Gentleman himself says that we need to enforce our existing powers.
	Section 59 of the Police Reform Act 2002 gives the police the power to seize any motor vehicles being used antisocially and to release them only on payment of prescribed fees. The power exists where a vehicle is being driven both inconsiderately or carelessly on-road, or off-road without authority, contrary to sections 3 or 34 of the Road Traffic Act 1988, and in such a manner as to cause or to be likely to cause alarm, distress or annoyance to members of the public.
	We believe that is a powerful tool. It enables the police to put an immediate stop to the antisocial driving, inconveniences the vehicle users, requires them to meet costs to get the vehicles back and provides a deterrent to further misbehaviour. It does not preclude a prosecution, but nor does it depend on one. Nor should the fact that the driver may be committing some other motoring offence for which he could be prosecuted rule out seizure. The requirement is only that there should be reasonable grounds for believing that he is driving the vehicle contrary to section 34 and causing alarm; for example, he could be committing some other offence, such as speeding, at the same time, and could be charged with that in preference to a charge under section 34.
	There is a requirement to warn, to give someone a chance to stop misbehaving, which is after all the main purpose of the police intervention. That may be where there is a problem of interpretation in relation to some of the issues that the hon. Gentleman raised. However, that requirement does not apply if it would be impractical to give a warning, and nor does it apply if an earlier warning had been issued on the same occasion to the same or a different person in respect of the same or a different vehicle. It does not apply if at any time during the preceding 12 months the person has already been given a warning.

Andrew Selous: rose

Andy Burnham: There is not a great deal of time left. If I can, I want to touch on several other issues that the hon. Gentleman raised.
	To ensure that all forces realised the full potential of the powers available, we issued further guidance a few weeks ago together with examples of best practiceI told the hon. Gentleman that we were doing work in this area. We also made several amendments to the regulations that the police had identified as beneficial by setting out detailed arrangements for seizure, storage and disposal. I assure the hon. Gentleman that the powers exist. The important thing is to ensure that all forces realise the full power of the measures at their disposal and to encourage them to use the powers fully.
	The power of seizure under the Police Reform Act 2002 is not the only power that is available. Many of the bad drivers who cause such concern are likely to be uninsured, as the hon. Gentleman said, or without a valid licence. Uninsured drivers are more likely than others to be involved in road traffic accidents, to be non-compliant with other road traffic requirements and obligations, and, perhaps, to be involved in other criminal activity. This year, we have taken action through the Serious Organised Crime and Police Act 2005 to deal with these problems. The offences are being more readily detected due to the increased use of police ANPR cameras. Until now, however, the only action that the police could take was to issue a fixed penalty notice or a summons. The police now have the power to stop such driving immediately. With effect from July, the police can seize a vehicle if a driver does not produce on demand a valid licence or proof of insurance and they have reasonable grounds for believing that the vehicle is being driven without either.
	We are taking further action to address the concerns that the hon. Gentleman has rightly raised. He will know that we propose to create an offence of causing death by careless driving in a Bill that is soon to come before the House. I believe that the measure will be welcomed by hon. Members on both sides of the House. We have a good range of powerful and proportionate measures to ensure that the sort of behaviour that we all deplore and that causes so much distress can be effectively addressed. At present, we do not believe that we need to add to those measures, but I agree with the hon. Gentleman that we need to work hard to ensure that the powers that we have are fully used.
	The motion having been made after Six o'clock, and the debate having continued for half an hour, Mr. Deputy Speaker adjourned the House without Question put, pursuant to the Standing Order.
	Adjourned at twenty-eight minutes to Seven o'clock.